Tips for Preventing Claims Denials

November 5, 2013

Claims denials are a source of revenue loss for many healthcare facilities, specifically for those in Ohio. Yet organizations are often unaware as to how to improve the claims submission process. This lack of knowledge can result in repeated denials and interruptions in cash flow. Plus, when claims are not appealed or resubmitted for review, it basically means that doctors are working for free. In order to ensure that payment is obtained for services rendered – and that extra time and money isn’t being spent processing denied claims, it is important for billing staff to be efficient the first time around.

Here are a couple of ways an Ohio billing service can help physicians prevent denials:

Regularly monitor submission reports to track the reason behind each denial.

Monitoring reports is one of the best ways to find problems and figure out ways to fix them – and a medical billing company can help physician practices do this. Submission reports can be reviewed monthly – or more or less often, depending on the frequency of denials at a particular practice – and billers should take into account the number of claims that are getting denied, as well as what the cause is behind each one. Some common reasons for denials include:

  • Untimely filing
  • Incorrect modifier
  • Incorrect coding
  • Missing or incorrect information

Implement policies to prevent claims from getting denied in the future.

After identifying the reason claims are getting denied, it is necessary to address those problems so that they do not continue to occur. An Ohio billing service will know the reasons claims often get denied and will work with standardized submission and resolution processes to ensure that maximum reimbursement is achieved.

At 5 Star Billing Service, we handle high claims volumes and excel in accurately coding, billing, and finding data entry errors to prevent denials. We submit claims daily to prevent untimely filing; and we ensure that our physician clients in Ohio are satisfied with our medical billing services and benefit from high-performing billing departments. Our employees have in-depth knowledge of billing and claims submission processes, and they pay attention to small details to make sure that claims are submitted error-free the first time around. This means less follow-up work for us and more on-time payments for our clients.

To learn more about medical billing services for physicians in Ohio, call 480-999-0180 or contact us online.

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