Receiving a healthcare claim denial is a frustrating and challenging experience for many, particularly when dealing with a serious illness or injury. Health insurance companies deny claims for many reasons, including:

  • Billing errors
  • Missing information
  • Issues with coverage limits and lapses

Even with these challenges, there are steps that you can take to minimize the likelihood of claim denial and ensure that your needs are met as smoothly as possible. Consider these action steps to keep your health insurance coverage airtight and your family’s healthcare needs met.

Review Coverage

Make sure you understand your insurance coverage, including what services are covered, what your deductible may be for various services, and if co-pays are needed. This will help to avoid those little surprise denials and out-of-pocket expenses that are hard to plan for.

Keep Good Records

Keep detailed records of all healthcare services you receive, including dates of service, the name of your provider, and any medications or treatments that were administered. This will give you accurate information that you can provide a medical billing specialist who is responsible for coding and sending on to your insurance company.

Double Check Billing Statements

Errors in billing happen, all the time. Double-check your statements to make sure that goods and services are accurately listed and coded. If you find errors, work with your provider billing specialist to get them corrected.

Complete Prior Authorization Procedures

Some insurance plans require prior authorization for certain procedures, treatments, and medications. Go through the extra step of obtaining this permission to avoid a denial that needs to be appealed.

Be Proactive

Communicate early and often with your provider about concerns and questions related to your treatment plan. This will help ensure that all services are medically necessary and covered by insurance.

Appeal if Denied

Don’t give up so easily if your claim is initially denied. Work with your insurance company and care team to appeal the denial, providing additional documentation and support that may turn around their initial decision.

Healthcare claim denials are common, but they are not set in stone. By following these steps, you can minimize your risk of receiving that disappointing letter in the mail and look forward to seamless and full support from your insurance company.

JJ Revenue Cycle Management: Professional Medical Billing in Fort Lauderdale

J3 Revenue Cycle Management offers premier medical billing in Fort Lauderdale and the surrounding area. Providing solutions that serve you, our valued customers, we serve as the efficient mediator between clients and insurance companies to make sure all needs are met. Our detail-oriented staff tends to each claim with integrity, professionalism, and dedication to making sure our highest standard of healthcare coverage and care are achieved. Contact us today for more information about our services.