How to Reduce Rejections with Denial Management in Healthcare?

1. How to Reduce Rejections with Denial Management in Healthcare?

2. Before we discuss on ways to reduce claim denials let us understand the top reasons causing claim denials in Medical Billing: • Missing or Incorrect patient details • Missing or incorrect provider and payor details • Duplicate Claims • Services already covered • Service not covered under the patients insurance coverage • Missed Timely Filing Limit (TFL)

3. Accurate Patient Demographic • Patient Name, Age, DOB, Gender, Address and Contact Number, Email along with relationship with the policy holder. • Insurance Name and contact details, plan details, policy start and expiry date, policy coverage details. • Allergies or major medical history • Copay, Co-insurance and Deductibles as applicable on the insurance covered • Payment method for patient responsibility

4. Quality Coding and Charge Entry • Medical Coding are mostly vulnerable to errors leading to major reasons for claim rejection and denials. • And the process of Charge Entry in Revenue Cycle Management is not just doing the data entry of charges, but also to add value by identifying any issues with the claims, procedures or fee schedule and making necessary correction to enhance the claim quality. • Having quality checks and regular audits and bring down the error percentage in these scopes and enhance first pass rate.

5. Claim Audit and Analysis • Every claim has a dead line called as the Timely Filing Limit (TFL) for submission with Insurance Company. • Effective Denial management aims at processing the rejected and denied claims within the stipulated TFL to avoid further hassle due to late submission.

6. Effective Account Receivable Follow up • Timely and regular follow up with Insurance companies by the accounts receivable team helps in expediting the claims reimbursement process. • Effectively following up requires additional time and effort to be invested by a dedicated team.

7. Outsourcing Denial Management to Medical Billing Company The best solution to reduce claim rejection and to handle claim denials effective is by partnering with an experienced Medical Billing Company who can handle the Accounts Receivable and Denial Management Services for you while you can focus on patient care.

8. About MGSI • MGSI is a 25+ year old national Medical Billing and Revenue Cycle Management Company located in Tampa, FL. • With cumulative years of expertise serving more than 600 physicians across the US, MGSI has the latest tools in place with experience working on multiple Medical Billing Software. • A multi- specialty Medical Billing Company guaranteeing maximum benefits and Cost Effective Revenue Cycle Management Solution. • To know more about MGSI call 877-896-6474 or login to Healthcare Denial Management – Medical billing Services| MGSI (mgsionline.com