Most Common Reasons for Medical Billing Claim Denial

1. Most Common Reasons for Medical Billing Claim Denial www.mgsionline.com

2. Introduction Most of the time physician practice affected by medical billing claims denials. To enhance the physician practice profitability and reduce the operational costs, you have to reduce the claim denial rates. Let’s discuss the medical billing claim denials reasons. www.mgsionline.com

3. Reasons for Medical Billing Claim Denial Incorrect Patient Identifier Information No Referral on File Claim Was Filed After Insurer’s Deadline Missing or Invalid CPT or HCPCS Codes Lack of Documentation to Support Necessity    www.mgsionline.com

4. Incorrect Patient Identifier Information To make a payment patient identifier information is plays a major role to identify the patients' insurance plan. Other data also cause medical claim denials. Such as Incorrect subscriber or patient name Incorrect subscriber or Patient’s date of birth Incorrect subscriber numbers Incorrect subscriber group number Insurance ineligibility www.mgsionline.com

5. No Referral on File If the claim submitted before the primary care physician‘s referral then the claim gets denied. www.mgsionline.com

6. Claim Was Filed After Insurer’s Deadline Claims need to be submitted before the deadlines (Timely Filing Deadlines (TFL)) www.mgsionline.com

7. Missing or Invalid CPT or HCPCS Codes CPT Codes and HCPCS Codes are used to identifies the procedures and service rendered by the physician. CPT – Current Procedural Terminology HCPCS – Healthcare Common Procedure Coding System. www.mgsionline.com

8. Lack of Documentation to Support Necessity   For some medical claims processing, the payer requires an additional document to adjudicate the claim. Such as Patient medical history Patient physical reports Physician consultation reports Patient discharge summaries Radiology reports Operative reports www.mgsionline.com

9. About US MGSI is the leading medical billing company in Florida US. We provide various services such as Cardiology Medical Billing Radiology Medical Billing AR Follow up Denial Management Medical Claims Processing etc. www.mgsionline.com

10. Do you have any queries? info@mgsionline.com www.mgsionline.com 1-877-896-6474 www.mgsionline.com

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