How to Reduce Claim Denials in Family Practice Billing

The family practice used to face the most daunting challenges in the medical billing process which is the claim denials. A study shows that almost 20% of claims were denied and 60% of claims were never resubmitted. This will ultimately decrease the healthcare practice revenue.

However, using some strategies, family practices can reduce the claim denials efficiently. In this blog post, we have shared tips to reduce claim denials in family practice billing.

Tips to Reduce the Claim Denials in Family Practice Billing

Reducing the claim denials is crucial for healthcare practices to increase practice revenue. Here are the tips and practices that can be implemented to reduce claim denials.

Related: How Modern Tech Can Help Manage Your Revenue Cycle

1. Ensure Precise Patient Details

Family practice care providers need to ensure collecting all the necessary information and details that are most required for the insurance part from the patients at the time of visit. 

Make sure the collect the necessary information which includes:

• Patient name
• Demographics
• Residential address
• Insurance information

Each collected information must be precise, small mistakes can lead to claim rejections.

2. Stay Informed About Insurance Policies

The insurance policies and coverage details will change. Staying up to date with the insurance policies and coverage details for your patients. It is possible to avoid denials because of non-covered services by being aware of the services that are covered by various plans.

3. Confirm Eligibility and Benefits

Before beginning any treatment, make sure the patient is eligible and has benefits from their insurance company. This process lowers the possibility of claim denials and aids in identifying coverage restrictions.

Related: Why Should You Use Eligibility Checks & Clearinghouses in OpenEMR?

4. Train and Educate Your Team

Make a consistent training investment for your administrative and billing team. They ought to be aware of the most recent changes to insurance codes, policy exclusions, and typical causes of claim rejections.

5. Adhere to Correct Coding Standards

Family providers need to ensure that the codes for all operations and diagnoses are correct. Make sure you are using the most recent CPT, ICD-10, and HCPCS codes to prevent coding errors that result in denials and rejections of claims.

6. Perform Regular Chart Reviews

Audit patient charts and billing records regularly to find and fix problems before filing claims. The quantity of claims that are denied might be greatly decreased with this proactive strategy.

7. Implement Pre-Submission Claim Checks

Make use of automated technologies for scrubbing claims, which check claims for problems before submission. These technologies can detect problems such as inadequate information, eligibility concerns, and coding discrepancies.

8. Follow Up on Claims Swiftly

Provide a mechanism for tracking and evaluating claims. Quick follow-up on rejected claims can guarantee that they are promptly amended and resubmitted, cutting down on the amount of time it takes to get paid.

9. Maintain Thorough Documentation

Medical documentation is the most valuable asset in medical billing. So, Completeness and maximum accuracy in documentation are necessary. To support the filed claims, make sure that all patient visits, surgeries, and diagnoses are thoroughly recorded.

CapMinds Revenue Cycle Management Solution for Your Healthcare Practices

Effective revenue cycle management is essential to improve healthcare practices’ financial health. 

To avoid the drawbacks, minimize claim denials, and improve your revenue cycle management, an expert must be put into use in your practice.

At CapMinds, we are bringing a comprehensive solution to make your billing and coding experience better. Our medical billing team expedites your entire billing process. Utilizing our Revenue Cycle Management Solution, your healthcare practice benefits from:

• 24/7 Support: Always available for your queries.
• Dedicated Client Manager: Personalized service for your practice.
• Efficiency and Accuracy: Streamlined billing, fewer claim denials.
• Financial Optimization: Maximize revenue, and correct underpayments efficiently.
• Enhanced Cash Flow: Timely collections, and improved financial management.
• Compliance and Security: Adhere to industry standards always.

We optimize your charges, submit your claims, on-time collection, reduce accounts receivables, identify underpayments, and increase your practice’s net collections, thereby better clinical and service expansion.

We also have a dedicated client manager who will be exclusively assigned to you. And the team will be available around the clock to assist with your queries. 

“Reach out to CapMinds to make your medical billing process easier and more effective”