Claim denials and rejections are two of the biggest obstacles in getting electronic claims processed and accepted by the payer. Unfortunately, they are a fact of life in medical billing and impossible to avoid. However, there are steps that can be taken to reduce the number of denials and rejections received by your practice to a minimum and ensure your electronic claims are paid:
- Verify practice/provider billing information
- If available from your EHR provider, enable up claim settings to help flag potential issues
- Establish claim submission workflow best practices
Check out my webinar:
I’ll walk you through the best practices around practice setup and let you know how Kareo makes the process easier.
Ensuring your practice is properly set up in your software system is essential for avoiding claim denials and rejections. In order to verify you are setting up your account correctly, you must first gather and input all the necessary information to ensure you are billing appropriately to each insurance for:
The practice information entered into your practice software should match the practice's credentials. Payers may reject any claims with submitted information that does not match what they have on file.
The provider's information entered into your practice software should match the provider's credentials. Payers may reject any claims with submitted information that does not match what they have on file.
Gathering the correct payer information before billing will ensure that the claims will not reject for invalid setup information.
All payer enrollments will need to be completed and signed by the practice and approved by the payer before claim submission can begin. This will ensure that the claims will not be rejected for setup information.
Your Standard Fees list will include all fee schedules, the effective dates of the schedules, the basis or "source" of the fee, and the status.
Please tune in for my webinar, Setting Up Your Medical Practice for a Smooth Reimbursement Process, where I will go over all of this and more!