If you’re able to tackle your most common denials, you’ll be well on your way to filing your claims correctly the first time instead of having to resubmit claims later. If you’re not posting and reconciling payments through your system regularly, you won’t see an accurate number of denials in your system, and keeping up with payments will be even more challenging.
As we mentioned, there are common claim denial reasons that many eyecare practices deal with. Let’s look at the top reasons:
1. Duplicate Claims – Two or more submitted claims that include repeated information about patient demographics, provider, date of service, and billing codes.
2. Payer Doesn’t Cover Service – The service you provided isn’t fully covered by the insurance plan your patient has.
3. Late Filing – Submissions filed after the claim submission deadline as outlined per payer.
4. Bundled Payment – Payments bundled into another procedure can cause payments to be made to another service provider.
5. Uninsured Patient – Patient can’t be identified as insured.
6. Coverage Termination – Coverage termination due to late or non-payment on insurance premiums paid monthly.
7. Payer Doesn’t Support Frequency of Services – Claims can be denied if the service wasn’t deemed a “medical necessity” by the payer.
If you’re being hit with these common denials we have a webinar that will walk you through the steps to take when these denials happen, and how you can avoid unpaid claims piling up or getting buried in paperwork.
Your practice is missing out on revenue when any claims go unfiled because your team isn’t sure about why the claim was rejected or denied. And we want to help you prevent that with our latest webinar on October 28th, 7pm CST.
We’ve consulted our insurance expert to show you how to read claims, investigate what went wrong, get them paid, and prevent future errors. Furthermore, this is an interactive webinar where you’ll answer questions that guide you to the best solution for each unsolved claim. You’ll also be able to ask any unanswered questions throughout the presentation, too.
Shane Shepherd, our in-house billing expert, will be sharing his tips and tricks from 14 years of experience in successful revenue cycle management. There’s no claim he can’t solve.