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Top Reasons Why Medical Billing Claims Get Denied

Top Reasons Why Medical Billing Claims Get Denied

When patients receive medical care and charge the bill against their insurance policy, it is the duty of medical practices in Wisconsin to file a claim. However, filing a claim doesn’t mean that the insurance company will immediately make the payment. There are times when the claim gets denied. Here are the top reasons why a medical claim can get denied:

  • Missing information
    It is only natural that claims with missing information get denied. After all, the insurance company has to ensure that the bill is for the right patient and for the right condition. Regardless if you are personally doing the medical billing services for your practice or are relying on a third-party, the filed claim should have no missing information like blank fields, wrong plan codes, missing modifiers, or incorrect social security numbers.
  • Duplicate claim for service
    You don’t need to seek medical consulting in Mequon, Wisconsin to know that claims submitted more than once will get denied. Never submit duplicate claims for the same beneficiary, same service provided, same provider, and same date.
  • Claim submitted beyond the filing deadline
    You only have a couple of days after a medical service to file a claim to the payer. Thus, make sure that your medical billing in Milwaukee is up-to-date. That way, you won’t have to worry about not being able to file a claim within the schedule.

These aren’t the only reasons why a claim can get denied. Rely on guidelines or seek consulting services to clearly understand how a claim can get accepted, rejected, or denied. Acuity Revenue Consulting is your partner for medical claims, so call us for your consulting needs.

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