If there’s one thing every medical biller wants to avoid, it’s denied claims. They set back progress, put your reimbursements in jeopardy, and add unneeded confusion and stress to an already difficult job. So why haven’t we found a solution to eliminate errors entirely yet? We may never be able to prevent every single error from coming up in a claim, but medical billing and coding software is your best shot at avoiding regular denials in your claims. Below, we’ve listed the most common medical billing denials that your practice should watch out for.
This may be the most common reason for a claim to be denied. If any information is missing—even one field—a claim will be denied. The easiest way to prevent this is by double checking claims and using software that detects missing information before a claim is sent.
Service isn’t covered by the provider
This denial will come back if the service billed for isn’t covered by a patient’s insurance company. This is why it’s so important to verify a patient’s insurance coverage at the beginning of every appointment, whether they’re a new or regular patient. Insurance providers and specific coverage can change at any time, so it’s important to check before billing.
A duplicate claim is one that has been processed more than once for the same service, for the same patient, on the same date. Since there’s no way of knowing whether there’s incorrect information when this happens, the claims will be denied and billers will have to resubmit.
Service already adjudicated
This error will occur if the benefits for one service get merged into the payment for another service, causing the service to look like it’s already been billed for.
Claim submission period has ended
Insurance companies have a specific window of time when they accept claim submissions. If you submit after the deadline, your claim will most likely be denied. The lesson here is to submit every claim in a timely manner, so that you don’t run the risk of missing out on payments.
Submit more clean claims with medical transportation billing software
Medical coding and billing software is without a doubt the best way to prevent and reduce billing errors. If you’re ready to submit more clean claims than ever before, sign up for a free demo with our Claimgenix team today!