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Primary Care Billing | 7 Steps to Reduce Claims Denial Rates in Your Medical Practice

Primary Care Billing

The current economic state is deteriorating, and a rise in unemployment and a number of businesses closing due to the coronavirus pandemic that is sweeping the globe put financial strain on a lot of people. Health-related practices aren’t immune to the effects of pandemics. Therefore, in the face of increasing numbers of claims being denied it is sensible to work towards decreasing their numbers, in order to increase the financial health of your business.

In all, 69% of leaders in healthcare have told the primary care billing that they’ve noticed more denials since 2021. When leaders reported the increase in denials, at least half stated that it increased by 10 percent or more while 12% said that the increase was as much as 30 percent. These numbers should make any physician pause and prompt an investigation to find an answer.

Primary Care Billing

Primary Care Billing
Primary Care Billing | 7 Steps to Reduce Claims Denial Rates in Your Medical Practice

The challenge of reducing the volume of denied claims that are out of control can be beneficial to practices of every size, from single-family doctors to multi-specialty large groups. Reduce the rate at which your practice is denied by following these seven steps.

  1. Verify Patient Information Up Front

Certain medical facilities are so crowded or overstaffed that they don’t have the time to review vital information regarding the patients they treat and diagnose. This could lead to the recipe for financial catastrophe, however. It’s important to make clear the importance of reducing claims denials. Around 42 percent of healthcare professionals informed their MGMA that they had prior authorization as the primary reason for denials.

Software tools can assist you to automate this process, which will save time by having your staff manually dial each request into providers to confirm the insurance status of every patient. If you do, you must take care of this job and you have to do it consistently throughout the course of time.

  1. Remind Patients of Their Responsibilities

A problem could arise from an inability to communicate the specifics of what patients are accountable for. A notice in the reception area can be a good place to start. It is also possible to include an easy form for patients to sign stating that they’ve been informed of the obligations for paying. Another way to share this information is to post this information to your website or include it as an article that you include in the periodic newsletter that you send to your patients.

  1. Update Staff Training/Onboarding

Sometimes cracks develop in an organization as a result of inconsistency (or inadequate) training for staff. Begin by having a meeting with your staff to remind them that they must supply all necessary medical records to justify the treatments and diagnoses that you provide. Any adjustments to the care plan must be documented and backed by evidence by providing codes that justify the need for extended hospitalizations for patients or for specific treatment methods.

Prioritize that staff becomes more accurate with medical codes. They may need the education to keep up-to-date. These concerns must be considered in your selection, hiring, and onboarding processes too.

  1. Submit Claims in a Timely Manner

This is something any medical professional can easily rectify. Make a batch of your claims and send the claims in accordance with your timetable. Find out why certain claims are not being processed. Did you make a mistake? Do your employees feel overworked to the point that they are unable to meet the required documentation requirements and submit claims on time? Determine the most common causes of delays and optimize your company’s capacity to react.

  1. Hire Consultants to Conduct an Audit

It’s sometimes difficult for the organization to look at its business in a neutral way. It’s possible that you don’t have the knowledge to recognize that your team requires improvement in the areas of primary care billing services and claims. Consultants who conduct a medical coding audit could be the solution you require to make things better for your staff.

  1. Upgrade Computer Systems

It is likely that your system isn’t up-to-date for a long time. However, a modernized configuration allows your employees to operate more quickly and effectively. Additionally, primary health billing provides the latest security technology and lets you deploy specific software specifically designed to manage claims denial. go services just click here.

  1. Use Software Designed for Managing Denied Claims

Make use of a complete software solution for handling rejected claims. It will display to your team the rejected claims as well as the reasons as the reason for not paying. Then, you utilize the software to make required corrections, and then submit your claim, right immediately.

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