Blog Details
Reducing claim denials is critical to maintaining steady cash flow and protecting your practice’s revenue. While no system is perfect, there are many proven strategies to significantly lower denial rates. Here’s how you can keep claims clean and payments flowing.
Verify Patient Eligibility in Real Time
Up-to-date eligibility checks prevent billing for inactive or ineligible patients—a leading cause of denials.
What to include:
These steps ensure claims are submitted only when payment is likely.
Code Accurately and Completely
Incomplete or mismatched codes trigger auto-denials. Always use the most specific ICD-10 and CPT codes supported by documentation.
Tips:
Submit Clean Claims on Time
Clean claims meet payer rules on the first submission. Over 80% of denials stem from simple clerical mistakes.
Follow Up on AR Promptly
Unpaid claims often age into write-offs without proactive follow-up. Track denials within 48 hours.
Invest in Staff Training & Technology
Your team and tools must evolve with changing regulations. Ongoing education prevents recurring errors.
What to include:
Final thoughts.
While you can’t eliminate every denial, a proactive, systematic approach dramatically improves your success rate. Small, consistent habits—verifying eligibility, coding precisely, following up fast—go a long way in securing your practice’s financial health.
Prevention is better than correction. Start with your billing workflow—your bottom line will thank you.
Elemmentor Box
Dr. Jenifer Olivia
Cardiologist, Maxcare Hospital
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