Medical claims get denied for a variety of reasons. When this happens, it ultimately holds up the revenue cycle. Resubmissions can sometimes take several months, so it is in your best interest to get it right the first time around. Keep reading and discover just a few of the most common reasons for why so many medical claims are denied.
Important Information Is Missing
It is important to realize that leaving out one piece of key information can lead to a denial. For example, leaving out a social security number will always lead to a claim getting denied. Claims should always be double checked for accuracy and completion before they are submitted.
Expiration of the Timely Filing Limit
If a claim is submitted beyond a specified number of days from service, it may be expired. An expired timely filing limit can present issues for your revenue cycle, as this issue often requires extensive considerations for the circumstances surrounding the claim.
Duplicate claims are not uncommon occurrences. Claims that are unknowingly submitted twice may lead to denials and create confusion in the process.
The Claim Is Not Covered By the Payer
It is important that members of staff check insurance eligibility before the time of service by calling the insurer. Sometimes, certain procedures are not covered under the patient’s benefits plan. This can be avoided if a practice does its due-diligence and check details before providing any services.
When benefits for a specific service are included in the payment/allowance for another service, the error of adjudicated services can present an issue for your billing process. For this reason, it is essential to understand where a claim falls in this adjudication process.
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Call MedHelp, Inc. today at (443) 524 4457 or toll-free at 1-800-275-6011 or visit us at www.medhelpinc.comand let our team assist you in choosing the right solution.