Medical billers never get it easy. They are responsible for keeping up with healthcare providers on solid financial ground through billing and payments, and satisfying patients with timely and reliable processing of their health insurance claims. In order to do this task, they require expert knowledge of the ever-evolving healthcare industry, accurate coding and the ability to process claims of different health insurance companies.
Let’s discuss 6 ways through which medical billers can avoid their claims from being rejected and denied.
- Submit clean claims: You must make sure that the originating documents such as superbill and patient insurance cards are in perfect legible handwriting. Claims which contain errors and/or are difficult to read generally take longer times to be processed.
- Get updated information: Make sure you update your patient information each time they visit. They will really assist you a lot in ensuring that you are reimbursed properly.
- Double-check coding: Clearinghouses do not always catch coding errors so make sure to double check your claims when you enter them. Medical Billing software which are up-to-date can really help with this process but it has to be compliant with current regulations.
- Patients generally do not understand their Explanation of Benefits (EOB). Make sure they understand the reasons why their claims have been denied or left unpaid.
- Make sure to regularly run reports from your practice management software to look for trends – the amount of claims denied and common reasons for them. Such metrics can also give you an insight into which insurance companies are causing most of the denials for your practice.
- Make sure you are processing claims reliably and quickly. Some insurance companies will reject claims if they are time barred so make sure you submit them promptly.
Prevention of claims problems is a great first step in keeping your providers and their patients happy, but sometimes you have to go the extra mile. A good medical billing software can give you an edge in succeeding despite today’s healthcare challenges.