8 Successful Tactics for Reducing Denied Claims 2024



Roughly 65% of rejected claims aren’t reprocessed for resubmission (Zindl, 2021). As one of the healthcare industry’s numerous challenges, the upward trend of denied claims persists, with many left unaddressed. This has repercussions for both providers and patients alike.

When denied claims remain unsubmitted, providers face substantial losses. Beyond revenue, these rejections strain staffing resources. Mitigating this issue demands proactive measures, such as educating staff, to reduce the volume of denied claims. Education helps tackle underlying causes and continually addresses shortcomings amidst evolving systems or updates.

What Are Typical Causes Behind Rejected Claims?

Claims are often denied for various reasons, primarily stemming from administrative and coding errors.

Administrative Errors Encompass:

• Absence of demographic details
• Eligibility discrepancies
• Duplicate submissions
• Missing filing deadlines
• Bundle payment issues

Coding Errors Involve:

• Date disparities
• Inappropriate code combinations
• Incorrect modifier application
• Insufficient medical justification

Moreover, documentation errors can significantly disrupt both administrative and coding workflows. Any inaccuracies or faulty information reflected on the claim form contribute to confusion, increased administrative workload, and a subpar patient experience.


https://www.allzonems.com/8-successful-tactics-for-reducing-denied-claims-2024/

Comments

Post a Comment

Popular posts from this blog

2023 Scary ICD-10 Halloween codes For Physician

Image
  With Halloween right around the corner, be on the lookout for some of these incidents that may require new ICD-10 codes. ICD-10 CM Code W49.01 – HAIR CAUSING EXTERNAL CONSTRICTION W49 . 01XA  is a billable ICD  code  used to specify a diagnosis of hair causing external constriction, initial encounter. A ‘billable code’ is detailed enough to be used to specify a medical diagnosis. ICD-10 CM Code X99.2 – ASSAULT BY SWORD OR DAGGER X99.2 is a non-billable ICD-10 code for  Assault by sword or dagger . It should not be used for HIPAA-covered transactions as a more specific code is available to choose from below. More specific codes – 7th Character selection: The appropriate 7th character is to be added to each code from category X99 Use X99.2XXA for initial encounter Use X99.2XXD for subsequent encounter Use X99.2XXS for sequela ICD-10 CM Code R44.1 – Visual Hallucinations R44.1  is a billable ICD code use...
Read more

Medicare ASC Payment System 2024 Update: New HCPCS Codes & Changes

Image
  Get ready for new codes , updated categories , and a few surprises : Pass-through power:  Five new devices (C1600-C1603) join the pass-through party, while some old friends (C1825, C1052, etc.) say goodbye. Remember to use the January 2024 ASC code pair file for billing. Biology guides the beam:  A new code (C9794) shines a light on radiation therapy guided by biology, including PET and CT scans. Dentists get dialed in:  104 new dental codes (CDT) are now accepted in the ASC system, with special indicators for ancillary services and non-office procedures. Don't forget code G0330 for facility fees on dental rehab, but keep it separate from medical billing  charges. In short, there's plenty to keep you busy in the new year!  This update gives you more options for billing various procedures and devices, so be sure to brush up on the details to ensure smooth sailing with Medicare. Key changes: More engaging and accessib...
Read more

Medicare Billing Update: Boost Reimbursement with G2211 Add-On Code

Image
To capture Medicare reimbursement for complex Medicare patient visits, you must know when to use this add-on code. To report the additional time, effort, and related practice expenses associated with caring for Medicare patients across the continuum of care, qualified healthcare providers can begin billing  HCPCS Level II codes  on Jan. 1, 2024. Evaluation and management of G2211 visits are complex due to the fact that they serve as the focal point for all the health care services the patient requires or because they are part of the ongoing care for a single, serious or complex condition. Consider This There are a few things to consider before you begin billing for this service: Medical Billing providers  are required to provide patients with longitudinal care. In the case of urgent care, consultants, second opinions, etc., providers who are not intending to maintain an ongoing relationship with the patient should not bill G2111. The add-on code may be billed by general p...
Read more