- Posted by Austin Swim
- On August 1, 2014
- 0 Comments
- denials management
Do your claims keep getting denied? You may need a better system of denials management.
There can be a number of reasons for denial on a claim. This is why it’s important to cover all of your bases first before you find out the hard way.
Get the Initial Steps Right
- Review verification of benefits
- Review and recheck clinical procedures
- Stay up to date on insurance laws & trends
- Track the process and re-evaluate ways to improve
Create Claims Management Cycle Process Efficiency
If your billing department can create a more efficient claims management cycle, you’ll see a decline in denials by default.
- Make an effort to get to know the vendor’s process
- Know how long it takes each specific insurance company to give results, and manage accordingly
- Check the status of claims regularly
- Choose an efficient software system
- Maximize resources with third-party substance abuse billing
Strategy in Appealing Claims
- Define a process and stick to it
- Know common reasons for denials and address the issues preemptively
- Give your team ongoing training on denials management.
By taking care of these process-oriented steps you can maximize the patient’s ability to get successful claims. Elevated understands the process of holding an insurance company liable for treatment of a patient. Elevated manages all of the appeals from start to finish, escalating to second and tertiary appeals when necessary.
Also see our article on increasing communication within your network for more tips.