Tips to Reduce Denials Rate & Claim Rejections and Increase Practice Revenue

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Tips to Reduce Denials Rate Claim Rejections
and Increase Practice Revenue
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Introduction

• Reducing denials rate and claim rejections are
  the most ideal approach to ensure faster payment.
• A rejected claim with mistakes impedes the
  payment cycle, affecting your practices revenue
  flow .
• Ensuring cleaner claims submission is the best
  approach to keep away from unnecessary claim
  rejections, denials and low payments.
• Analyze your billing process to track and monitor
  the most common reasons for claim rejections.

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• If there is a sudden uptick in denials and
  rejections, you should set aside the effort to
  survey your billing process .
• You may find that most of the claim denials are
  originating from one specific insurer or a
  specific diagnosis code prompts more rejections.
• Revealing the top reasons behind denials can help
  you rapidly improve the clean claims rate.
• A minor change in insurers prerequisites could
  be liable to an increased rejected claims.
• Let us talk about how to submit clean claims to
  reduce denials rate claim rejections through
  proper denial management.

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Ensure Insurance Coverage and Eligibility

• Before providing service, the front office
  commits to check insurance coverage and benefits
  eligibility. After completing the verification,
  the clean claim is submitted to the payers, this
  process reduces the chances of denials In
  specific cases, it might be obligatory to get a
  referral or authorization number as these claims
  may get denied without a substantial one.
• Authorization regularly is dynamic over a
  particular date and may get terminated if not
  utilized during that time. A few authorizations
  cover a timeframe as well as a predetermined
  number of treatments or visits.

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• Nonetheless, note that getting earlier approval
  is as yet not an assurance of payment. The
  submitted claim must satisfy the accompanying
  conditions
• It must be upheld by medical necessity
• It should be filed by the provider
  mentioned in the referral
• It should be filed within timely filing
  prerequisites

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Use AI to Manage Denials

• Applying creative trend-setting innovation
  empowers providers to build revenue productivity
  and accuracy.
• AI directs investigation to recognize the root
  cause and ensure error-free claims from the front
  end to avoid denials.
• You can track, measure and report on trends by
  physicians and payers. This information will
  assist you to analyze denial trends, figure out
  what assets are expected to execute solutions and
  track report progress.

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Stay Current with Payer Requirements

• Medical billing rules and guidelines are
  continually changing, requiring doctors and
  administrators to invest time and cash on
  proceeding with instruction, directly affecting
  the income and benefits of the practice.
• There are a few codes that are stopped every
  year, there are a few different codes which are
  acquainted every year with reflecting regularly
  performed methods. Our medical billing company
  stays on top with current rules and regulations.

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Outsourcing is the Best Choice

• For healthy cash flow, you have to outsource your
  medical billing to a medical billing company that
  has an effective denial management team. We use
  effective strategies to handle your denials such
  as,
• To increase the success rate of appeal, we use a
  standard appeal template with approved standard
  verbiage.

• Prioritizing denials during the insurance follow
  up and denials will be worked within 48 hours.
• A Few out of every odd denial should be
  appealed. A few denials require dispute/appeal
  with the payer. For that, we defined the dispute
  strategy clearly what is worthy of dispute
  acceptable.

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About us

• MGSI offers proficient medical billing and
  coding service to ensure your practice revenue
  cycle efficiency.
• We will assist you to resolve issues with
  denials and rejections.
• Become a partner with us and learn how we enable
  your practice to oversee claim denials. To know
  more about our services visit us
  at www.mgsionline.com

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Thanks!
Any questions?
You can reach us at 877-896-6474 info_at_mgsionline.
com www.mgsionline.com