Modify Your Claim Denial Management Services and Protect Your Earned Revenue

October 26, 2021, bestturtlebeach

Are you struggling with a pile of unpaid medical claims? If so, then it’s the right time to take appropriate actions and revolutionize the claim denial management services. Whenever you discuss or hear about successful revenue cycle management, it’s very important to build and maintain an effective system that manages the rejected or denied claims efficiently. Which is crucial to saving your health care practice from losing the hard-earned revenue. Here’s a question that arises: why are optimized lab claim denial management services crucial for the overall success of the RCM system? Let’s discuss it in detail.

One can’t deny the fact that, in the current reimbursement environment, almost every clinical practitioner is worried due to the frequent denials. It has not only become the leading cause of revenue loss but the frustration for the practitioners too. The only way to initiate the billing collections is the implementation of the right denial management solutions. Having a systematic procedure to deal with the denied or rejected medical invoices will create a huge impact on your practice’s productivity. Below are the best steps to modify your claim denial management services and improve the overall cash flow.

Don’t Stop Claim Tracking
Most of the time, health care providers don’t stay connected with the payers after submitting the claims. However, it’s crucial to keep a streamlined method to follow denied claims progressively. Make sure that your billing staff keep following up with the payers, to know the current status of the claim, either paid or unpaid. If a claim gets denied, you become better able to rapidly address and resubmit it. It’s a fact that a denied claim can result in a significant delay in reimbursements. Nevertheless, the quick response to denied or rejected claims can shorten your cash cycle.

No doubt, tracking and monitoring the claims isn’t easy, particularly, when you file manual or paper-based claims. Therefore, the industry experts always prefer to submit the insurance claims electronically. Electronic billing solutions not only enhance the accuracy and efficiency of the entire revenue collections management process. But it also makes it easy to track the journey of a medical claim i.e. from submission to billing collections. A single click on your computer systems will let you know, either your claim is rejected or is being processed further.

Find Out The Reason Behind Denials
In order to enhance the efficiency of the claim denial management services, it is imperative to identify the major causes that cause claim rejections or denials. When a claim gets denied, the billing department should immediately take action and examine the claims thoroughly to uncover and fix the potential errors. Utilizing innovative software for managing lab claim denials can be amazingly useful, as it makes the process of claims examination easy and simple.  It could help the billing staff to discover places for a change. For example, if the claims get denied due to coding errors, you become able to eliminate such errors and prepare the successful appeals to resubmit the claims.

Improve Claim Scrubbing Process
Claims scrubbing is the most important part of the lab revenue cycle management. It is the process of catching and eliminating errors in the medical invoices_before they are submitted to the insurance companies. So, the best solution to enhance the efficiency of the claim denial management services and get timely reimbursements is_ you have to improve the process of claim scrubbing first. This viably diminishes the number of claim denials/rejections, increases the clean claims rate and eventually on-time payments.

Train Your Staff to Resubmit the Claims
We have several times discussed that staff training is very important when it comes to managing medical claims. So, make sure that your billing staff is efficient enough to address the denial in a seamless manner. Hence, after tracking claims, identifying the reason for denials and claims scrubbing. The next important step is the resubmission of claims. For this purpose, denial managers should categorize the claims according to the filing time limits. Give preference to those cliams_that have tight deadlines for resubmission.

Make sure that your billing staff has a complete understanding of the given time windows of the payers and submit the claims accordingly. If it’s challenging to hire a trained in-house billing team, you can also get the assistance of the denial management solution providers. They are well-trained to manage the denied claims efficiently and reopen the reimbursements. In this way, you can also get rid of the excessive administrative and financial burden.


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