7 Ways to Reduce Your Claims Denial Rates

Many people are struggling financially as a result of the economy’s current state, which has seen an increase in unemployment and the closure of numerous businesses in the wake of the global coronavirus pandemic. Similarly vulnerable to pandemic-related downturns are health practices. Therefore, in light of the rising number of claims denied rates, it makes sense to make an effort to lower them in order to preserve your organization’s financial stability.

At least half of leaders who reported an increase in denials said the increase was up to 10%, with 12% saying the increase was up to 30%. Any healthcare professional would be concerned by these statistics, which would make them look for a solution.

7 Ways of Your Claims Denial Rates

1. Double-check patient data right away

Some healthcare facilities simply do not have the time to check important patient information because they are overworked or overloaded with patients. However, this might be a recipe for financial ruin. You should emphasize the significance of lowering claim denials. The majority of denials, according to 42% of healthcare professionals.

Train your staff to obtain this crucial data as soon as possible, such as when making an appointment or at check-in time for a patient.

2. Remind Patients about Their Duties

Failure to adequately explain the specifics of what your patients are responsible for could be one issue. A sign in the lobby is a good place to start. A standard form that patients must sign acknowledging that they have been informed of their financial obligations can also be included.

Posting this information on your websites and including it in an article in the newsletter you send your patients on a recurring basis are additional ways to distribute it.

3. Refresh Staff Onboarding and Training

Sometimes a lack of consistent or adequate staff training causes cracks to appear in an organization. Start by gathering your staff and reminding them that the diagnoses and treatments you provide must be supported by all necessary clinical documentation. Changes to the care must be noted and supported, for example, by supplying the codes to support longer patient stays or a specific treatment approach.

Make improving staff accuracy in medical coding services as a priority. They might require the training to stay current. Your hiring, onboarding, and recruitment processes for employees should take into account all of these issues.

In the US,  medical claims denial rates has increased during this time by 11%, with 13.1 percent being the highest denial rate.

4. Send in claims as soon as possible

According to market research, 7% of the healthcare professionals polled believed that “timely filing” problems were the primary reason for denied claims. Any medical team can quickly and easily fix this. Send in a group of claims at once and on time. Determine the cause of some of the delays. Was it a mistake? Are your employees so overworked that they are unable to meet the deadlines for filing and sending claims? To improve the responsiveness of your organization, identify the primary causes of delays.

5. Employ Professionals to Conduct an Audit

An organization may find it challenging to view itself objectively. You might not have the knowledge to recognize that your team’s claims and billing processes need to be improved. Although the office appears to be running smoothly on the surface, there may be some issues due to a knowledge gap, such as in medical codes. You might just need the assistance of consultants performing a medical coding audit to get things back on track with your team.

6. System Upgrades for Computers

Your computer system probably hasn’t received an update in a while. Medical practices place a high priority on minimizing risk, so managers may be concerned about downtime when changing a computer network, installing the most recent version of the operating system, and installing essential software. However, a more up-to-date computer system enables your staff to work more quickly and productively. Additionally, it offers you the most recent security safeguards and enables you to deploy specialized claims denial rates management software.

7. Utilize applications created for managing denied claims

Don’t try to get by with organizing and processing claims in a generic computer programme before submitting them to insurers. Utilize a comprehensive software programme to handle rejected claims. Your team’s denied claims will be displayed, along with the justification for not paying. Then, you immediately resubmit the claim after using the software to make any necessary adjustments.

Reduce the Number of Rejected Claims as a Priority

Your organization’s revenue flow will significantly change if you focus on reducing the percentage of claims that are denied.

If fewer claims are denied, your budget may have more leeway, allowing you to hire more staff or make equipment upgrades that will help the practice and the patients you serve even more. View our educational video on claims denial management right away to get a better idea of how it will operate in your office.

How to start a medical practice?

There isn’t a set procedure for opening a medical practice. Hiring a qualified consultant who has experience opening medical practices, is aware of the pitfalls and challenges, and can provide you with advice on medical malpractice insurance and workers’ compensation may be worthwhile. After all, specifics of launching a business vary by specialty, and some laws and regulations are state-specific. A qualified consultant will comprehend the risks and assist you in making the right plans. While some new practices might find a turnkey location, others might need to hire contractors to furnish their new offices. Overall, when starting from scratch with your practice, you must have a lot of common items on your checklist.

Main Points

• It’s more crucial than ever for medical organizations to lower the number of denied claims because people are under more financial strain.
• A rise in claims denials is predicted by at least 69 percent of healthcare executives for 2021.
• Before you diagnose and treat patients, make sure your staff checks their insurance status.
• Patients should be reminded of their financial obligations to prevent confusion or late payments.
• In order to address mistakes that could result in denied claims, retrain staff as necessary, and enhance staff onboarding.
• Utilize specialized claims denial rates management software to increase productivity and cash flow

Connect with medical practice consulting services to optimize your billing and clinical operations efficiently.