The Importance of Denial Management

A big part of an efficient medical billing process is what is called “denial management”. This is where most offices falter and lose money. Denial management is an important step that is often overlooked by doctors and staff because of lack of follow through by the office.  We find that claims will be rejected by insurance companies and end up “stacking up” over time if someone isn’t on top of them daily, reviewing and correcting issues, and resubmitting them.

There several main reasons a claim is rejected. Two of the most important reasons are:

• the office is using outdated medical codes.
• the patients contact info doesn’t match what the insurance company has on file. With the traditional set up, there are staff members in the office that are tasked with trying to keep this information up to date, as well as trying to stay educated on all the new medical codes that get released by the government. In fact, the number of codes will be almost double what they are now by Oct 1, 2014!

Our iClaim practice management system makes these patient demographich issues are a thing of the past. Patient demographichs such as contact info andinsurance status is updated real time as our system can automatically pulls data directly from the insurance company and creates a patient chart with one click! This means that medical practices not only get up-to-date name, address, etc. but can also see immediately if the person’s insurance is current, co-pay amounts, etc.

Our iClaim system comes with the entire database of medical codes. All updates/additions/deletions are being done by our technology partners (not you) automatically! So you are always up to date and will usually know more about updated codes than the doctor and his/her staff will know!

“Why would a doctor even need to outsource if iClaim is so awesome?” Doctors and their staff have many things they must do throughout the day, removing the billing aspect allows them to focus on quality of care for patients, which is what they would rather be doing anyway.

To understand more about what is involved in denial management, visit this article. (You must sign up for free to read it)

At Vitruvian MedPro, Denial Management represents an importact aspect that is embedded within the medical billing cycle.  Denials are worked consistently to make sure that medical practices get their claims paid consistently.