In a recent survey conducted among various insurers by the department of health and human services, it has been found that the denial rate of the applications for claims have been considerable in the last few years. In this competitive scenario, frequent rejections could be deterrent for any healthcare facility or individual’s practice. This leaves us with an important question, how to overcome these denials? Let us know a few pointers that can help healthcare facilities.
The first way involves accuracy in the information of the patient, as one of the biggest reasons for denials is incorrect patient information. Another important point is to ensure if the patient is still covered under the insurance benefits and if the insurance information is updated. The insurance provider should also be contacted to find if the healthcare facility is included in network of participants. The file of the patient should also be checked for any prior referrals from the primary physician along with checking for prior authorizations. Valid CPT and HCPCS codes should be included correctly wherever they are applicable. Last but not the least claims should be filed on time before the timeline lapses. These points if followed can help many providers avoid many denials.