The leading causes of denials and how to prevent them

Author/s: 
Romeo, Tom
Date Added: 
May 15, 2019
Journal/Publication: 
Physicians Practice
Publisher: 
Modern Medicine Network
Publication Date: 
May 9, 2019
Type: 
Practice Management Reviews and Guidelines
Format: 
Article

RPR Commentary

A brief summary of the most common reasons for insurance claim denials and what to do about them.

Abstract

Each new denial is essentially a revenue leak. Even when claims are recovered, the costs associated with that recovery must be subtracted from patient revenue. Recent data put that recovery cost at roughly $118 per denial. Factor in the lost revenue from your unrecovered claims and it’s clear why denials are a painful financial drain on practices.  

What makes denials so frustrating is that many are avoidable. The leading causes are well known, and it’s possible to prevent these leaks before they occur. The key is having processes in place to identify and correct errors and omissions before a problematic claim is ever submitted.

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