Hawaii
Kauai
01.
Medical Coding Errors
Incomplete documentation
02.
Lack of Medical Necessity
03.
01.
Coding errors, such as incorrect use of CPT or ICD-10 codes, are a common cause of denials, leading to claim rejections and delayed payments.
02.
Incomplete documentation, such as missing patient information or insufficient medical records, can result in denials due to insufficient evidence of services provided.
03.
Lack of medical necessity is another prevalent reason for denials, where payers deem certain services or treatments as not medically necessary based on their criteria.
Preventing denials requires proactive measures, such as conducting regular audits, ensuring accurate coding and documentation, and staying updated on payer policies.