Receiving a medical bill claim rejection can be exceptionally frustrating and costly. The more rejected claims your practice sees, the more financial losses you will suffer because of denied reimbursement from insurance plans. Fortunately, there are steps that you can take to minimize the impact of these rejections and prevent them from occurring in the first place.

Accurately Enter Patient and Insurance Data

Accuracy is essential in medical billing; mistakes or omissions could result in claim rejections. Medical billers must double-check all information concerning the patient and their insurance before filing a claim to avoid any discrepancies that might cause the submission to be denied. Ensuring that every field is filled out correctly and with valid information can save medical professionals time and money by eliminating the need to resubmit rejected claims.

Verify Patient Eligibility Before Submission

Verifying patient eligibility before medical bill submission is a crucial step in medical invoicing that saves medical offices from rejection because of precertification and eligibility requirements. However, medical billers should make sure that their research is up to date.

Patients may have updated benefits or be covered under a different plan since the last visit, making it essential for medical billers to double-check eligibility before submitting medical claims that can delay reimbursement and complicate medical billing processes.

Double-check the Accuracy of Codes

As medical billers, it is important to ensure the accuracy of the medical billing codes submitted. Incorrect codes can lead to claim denials, making accurate medical billing codes a critical responsibility.

For this reason, medical billers should always double-check that medical billing codes are up-to-date and correct before submitting them. Double-checking codes can save medical businesses money, preventing claim denials and other unnecessary issues.

Review Billing Rules

Different payers have different rules and regulations regarding how claims are submitted, so medical billers need to review the billing rules of each payer to ensure that all claims are being submitted correctly.

Utilize an Automated System for Claims Processing

Using an automated system for claims processing, such as medical billing in Fort Lauderdale, can help ensure efficient, accurate claims submission. This technology-based approach streamlines the process, reducing errors and omissions that can cause costly rejections from insurance carriers or other payers.

The use of an automated system prevents data entry mistakes by pre-validating patient information, so accuracy is increased, and turnaround time to submit claims is greatly improved for maximum revenue potential.

Get Authorization Before Services

Medical billers should obtain precertification or other authorizations before performing any services as this will ensure that the insurance company is aware of the services being performed and can properly process the claim.

Submit Claims Electronically

Electronic submission of claims yields many benefits. It reduces errors that can occur through manual entry and helps speed up the claim processing time for a smoother transaction process for the patient and provider. From the provider’s standpoint, simplified and faster claims processing allows for greater efficiency.

Stay Informed About Changes in Regulations

Medical billers should stay up-to-date on changes in regulations and billing guidelines to ensure that all claims are being submitted correctly. This can help them avoid rejections that are based on incorrect or outdated information.

Even the most expert medical billers can find themselves with many rejected claims. You can ensure that your claims are clean and error-free by taking a few minutes to double-check your work before you submit a claim. If you need help staying on top of billing compliance or increasing your allowable reimbursement levels, contact J3 Revenue Cycle Management today.