Are Your Medical Billing Claims Being Denied?

Are Your Medical Billing Claims Being Denied?

If you’re a physician and your medical claims are being denied, are you getting reasons why or are you simply eating the charges as a consequence of doing business?

In the realm of things, some claims will be denied legitimately, but far fewer medical billing claims than you think will be denied in this manner if you outsource your billing.

If you are still doing your own coding and billing, this is the number one reason for claims being denied by the carrier. Most practices are too busy to keep up with the coding changes that can happen many times in one year. With day to day goings on, your patients and the crisis du jour that can happen, sometimes keeping up with the ever so small but oh so important coding changes for your medical billing can take a back seat.

If the coding isn’t exactly in line with the medical billing, then your medical billing claim runs the risk of being denied.

Another reason claims are denied or partially paid is that even though you may have rendered multiple services to a patient but only put down one billing code. Your staff may or may not have time to follow up.

This is another fabulous reason to outsource your medical billing. Not only will your billing partner keep up with the coding but they will notify you when they see a pattern of coding in your medical billing that can lead to claims rejection or partial payments, and last but not least, should a claim be rejected, your medical billing partner will file your appeals for you.

View all Articles by: Melissa Clark, CCS-P