Every medical practice deals with denials, but what if there was a way to reduce the number of denials your practice receives significantly?
Outsourcing your medical billing to a third-party company is one way to ensure that your practice follows best practices regarding insurance verification and prior authorizations, medical coding, account reconciliation, AR management, and financial reporting.
Let’s explore five key ways that a medical billing company can help you with denial management:
Table of Contents
1 – Insurance Verification And Prior Authorizations
One of the primary causes of denied claims is incomplete or incorrect information on file for an insured patient. An experienced and knowledgeable medical billing company can help in this area by verifying insurance coverage before any services being provided. This helps ensure that all necessary information is gathered upfront so you don’t encounter any surprises down the road. They will also assist in securing prior authorizations for any procedures or treatments that require them. All of this up-front work can help prevent denials due to incorrect or incomplete information on file.
2 – Medical Coding
Medical coding errors are another common cause of denied claims; inaccurate codes can lead to delayed payments or outright rejection of claims by payers. A good medical billing company will have certified coders who understand the complexities of current coding guidelines and regulations. They will be able to review your existing codes and make sure they are accurate and compliant before submitting them for payment. This helps avoid delays in payment due to incorrectly coded claims.
3 – Account Reconciliation
Medical billing companies can also help ensure accurate account reconciliation between payers and providers by periodically auditing insurers’ statements for accuracy and completeness. They will compare bills sent out versus payments received to make sure nothing slips through the cracks; if discrepancies are found, they will work quickly to rectify them so that your accounts remain balanced at all times. This ensures that you aren’t left holding the bag should an insurer reject or delay payment due to an inaccurate statement or bill error.
4 – AR Management
Accounts receivable (AR) management is another crucial function handled by many medical billing companies; they will monitor unpaid invoices closely and take steps such as filing appeals if disputes arise between payer and provider. They may also take proactive steps, such as sending follow-up letters or making phone calls to secure payment in a timely manner so that your practice doesn’t experience any unnecessary losses due to unpaid bills from patients or insurers.
5 – Financial Reporting
Finally, many medical billing companies offer detailed financial reporting, which provides insight into areas where improvements may be needed for your practice to become more efficient and profitable overall Medicare Advantage plans. This kind of analysis may reveal opportunities for cost savings as well as areas where better processes could result in improved cash flow—both of which lead directly back towards helping manage denials more effectively over time.
Conclusion: Outsourcing Simplifies, Saves, And Strengthens Your Practice
Denial management is an ongoing process that requires diligence and attention to detail every step along the way; fortunately, modern technology has made it easier than ever before for practices large & small alike to outsource their medical billing needs without breaking the bank in order to do so successfully and efficiently.
