Healthcare departments have a significant influence on your practice. They can also cause significant damage to the income revenue stream when facing claims denials. When your practice faces constant rejections, it casts a poor influence on the cash flow and affects the practice as a whole. According to other American academies, physicians’ practices suffer close to 5-10 percent revenue loss due to constant claim denials. According to research by the Medical Group Management Association, there has been a 69% increase in the rejection of denials since 2021. This status is a red light and demands prompt solutions. Further, you can outsource your billing tasks to professional medical billing practices.
One can also prevent denial by understanding denials’ root causes. Detailed codes fall into four families, these are:
For instance, CO-4 is utilized when there is inconsistency with procedural code and the modifiers used or required modifiers are missing for adjudications. You can prevent this by using the relevant modifiers for the procedure. PI-204 comes in when equipment, services, or any other drug is not included in the patient’s current benefit plan.
The following practices can bring the best solutions to staying organized and overcoming the denials:
Try to meet the deadline in the best possible ways. Try to meet the deadline set by the company.
Due to constantly changing regulations and payer rules, many hospitals and practices need advanced technology and professional staff to manage denials effectively. Outsourcing revenue cycle management to experts like prgmd, who have expert denials management teams, can be a profitable, cost-effective solution. By establishing medical billing benchmarks, reducing backlogs, identifying root causes of denials, and augmenting your revenue cycle teams, medical billing services like Physicians Revenue Group can help you achieve these goals.