An Estimated 30% of Medical Claims are Denied — Here are Some Ways Out

The Center for Medicare and Medicaid Services reports that 30% of medical claims are denied, lost, or ignored as a result of provider errors.

According to a common statistic in the industry, a whopping 30% of medical claims either result in a denial, a loss, or an unanswered response. This may lead to a backlog of unpaid claims, resulting in delays in payments to your practice. Thus, you may end up spending more resources on claims management than on patient care.

If increased claim denials are hurting your practice's bottom line, here are some ways to help you out: 

1. Improve Documentation

Incomplete, incorrect, or illegible documentation makes it difficult to process claims. Ensuring that all documentation is accurate and complete can help reduce processing time and prevent claims from being denied. 

2. Perform Accurate Eligibility Check

It is important to perform accurate eligibility checks to ensure that the coverage is even up with the treatment cost. Check that the patient is eligible for the services being provided. Also, make sure that all paperwork is complete and that all necessary signatures are present. 

3. Ensure Timely Claim Submission

Keep track of all your claims and submit them on time. Late claims can cause delays in payment and may even result in the claim being denied or sometimes rejected. Also, be sure to send all claims to the right payer. 

Lastly, it is a good idea to keep track of any denied claims and to contact the payer for a resolution if possible. This includes appealing any denied claims and requesting a reconsideration if necessary.

Taking these steps can help you reduce denied medical claims. An outsourcing firm that handles claims denials can be a lifesaver when you don't wish to divert attention from patient care to claims management.