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Medical Billing

Medical Billing is the most significant part of the revenue cycle and it is challenging part of healthcare business. Practices need to submit clean claims for faster reimbursements. As a result, their practice does not lose revenue in the form of denials. Also, being an independent practice, you lose money due to claim rejections and it adversely impacts your overall collections. If you have an in-house billing team and suffering from claim denials, outsource billing to Medical Billing Company. As a result, it helps you to focus on patient care in a much better way.   

Why to Submit Clean Claims

Accurate Claim Submissions increase the chances of getting payments on time. In addition, you can save your time because resubmitting claims takes a lot of time and effort. Also, you do not suffer from unwanted revenue losses which harm your Revenue Cycle. In addition, when you submit a claim, the insurance company reviews it. If it is accurate according to the services rendered and the patient information is authentic, they pay the claim. Otherwise, you face denial or rejection. There are two big reasons why your claim was not accepted in the first place:

Reason of Denials

  • If the claims are duplicate, they are not paid by the insurance company
  • Submitting the claims for services that are not covered by the insurance leads to denials
  • Missing information in the claim
  • If there is no prior authorization, the insurance payer denies the claim
  • Submitting the claim after the deadline leads to a denial

Reason Behind Rejections

  • Not meeting the defined requirements before submission like missing important information
  • Wrong patient name, incorrect insurance policy number mentioned in the claim

Medical practices can rectify the errors and resubmit the claims. In addition, you do not have much time to think about why you face claim denials. So, you need to follow a proactive approach before submissions. Otherwise, delayed or no reimbursements will create a financial headache for your medical practice. Thus, the best approach is to check thoroughly before submitting the claim to the payers.  


Steps That Can Improve Clean-Claims Submissions

There are certain steps that can help you reduce the chances of claim denials. Submit Clean Claims to improve your practice revenue.

  • Verify the patient information properly, the name, insurance number, address and other important details before submission. If you find any error, try to rectify it before submitting the claim
  • Introduce an insurance verification system before scheduling the appointment. It will reduce the hassle of resubmitting the claims.
  • Keep an eye on prior authorization requirements before time.
  • Adding the details of diagnosis and the details of treatment
  • Incorporate technology in your practice to avoid manual processes
  • Use EHR and medical billing software which will reduce the chance of errors
  • Avoid manual data transfer to Submit Clean Claims every time