Always Appeal Your Denied Medical Billing Claim

It is a well known fact that everyone is human and we are all prone to make mistakes from time to time. Often times, your medical billing personnel could end up miscoding an item just because they are not up on all of the latest rules regarding ICD-9-CM or CPT rules. Because of the chances for a miscoded item being so high, it is always important that you know how an appeal can help you when your medical billing claims get denied.

You may already know this, but there are a good deal of practices that will actually lose a good deal of money every single year because they do not dispute any of the denied claims that they receive every single year. So, if you realize that you can bring a good amount of revenue back into your medical practice, why not dispute all of your denied claims? Be sure that if you have denied medical claims sitting and waiting for an appeal that you do not just let them sit there. This could cause the small window of time you have to appeal the claim to lapse.

Some of the things that you will want to be on the lookout for when trying to recognize a denied claim that is worth refuting are quite easy to remember. Certainly, it is important to remember that there can always be the sneaky problems of coding errors. In certain cases, there is always the problem of errors during the recording process itself. This can be as simple as a goofed number such as an incorrect birth date.

If you have a certain medical billing claim that has been denied, your next best step is just to let your medical billing vendor look into it for you. Once an error is found and you begin the process for appeal, the corrected paperwork can usually be re-submitted for further clarification. Always keep in mind that if you refute your denials, it puts more money into the pocket of your practice.

View all Articles by: Melissa Clark, CCS-P