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Denials: What Cause Them? How Can You Prevent Them?

Denials: What Cause Them? How Can You Prevent Them?

Every denial siphons off from your revenue. Claims can indeed be recovered, but the costs associated with it will be subtracted from the patient revenue. Frustrating, isn’t it? What’s even more frustrating is that a denial can be avoided!

What is a denial?

In comparison to a rejection, a denial, refers to a claim which has been received and reviewed. Yet, the claim is still found inadequate by the health plan or payer.

Furthermore, denials are not accepted for resubmission. Your next option to push them through the system would be to make an appeal. Yet, if you check the process with consulting services, you will see that appeals can be quite costly.

What causes a denial?

The ultimate reason for a denial would be the fact that a patient does not qualify for care on the terms set by their insurance plan.

Other common causes of denials include:

  • Incomplete Information
    Even a simple omission of details in the date of birth can lead to a denial.
  • Inaccurate or Duplicate Billing
    A clerical error in the office can cause similar claims to be sent and result in a denial.
  • Delayed Filing
    Missing the deadline can cause your claim to be denied.

How can you prevent a denial?

  • Have your practice audited regularly with the help of Medical consulting in Mequon, Wisconsin.
  • Train your staff and keep them updated for key error points that can lead to denials.
  • Automate your billing process.
  • Benchmark your progress to see how much profit you have regained.

Do you have other concerns on the topic?

No matter what queries you may have in mind, Acuity Revenue Consulting will address your concerns. To reach us, you may other speak with our representative through a call or by leaving us a message in the comments below.

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