The Three Main Causes of Claim Rejection

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August 26, 2016 | Aptus Associates

Claim rejection is a common occurrence in the medical field. Insurance companies are tight-fisted when it comes to dealing out the proper payment to doctor’s offices and it takes a very precise eye to keep up with the demand. Hopefully, only about to four percent of your claims will be denied but to make sure they don’t, we’ve got a few reasons why they might be to help you prepare perfect claims. After all, understanding what causes claim denial can help you prevent it.

Here are the top three causes of claim denial

  1. Error in Data entry. If you enter a patient’s birth date wrong, mistype a last name, or a finger bumps a nearby number when inputting the insurance code, the insurance company will deny your claim. By simply double checking everything inputted and verifying the information, you can fight claim denial before it starts
  2. Ineligibility. If the patient doesn’t have a specific type of insurance with a company, or if their policy has lapsed, they are ineligible for payment. Many people have lost their jobs, and with their jobs, health coverage. There is eligibility checking software and you can simply call an agent of the insurance company to verify policies to avoid this mistake.
  3. Non-covered services. Obviously, if a patient’s insurance doesn’t cover a certain procedure or visit, it can’t be paid for. Double checking the policy information to ensure the insurance is paying for what the patient has designated is one important part of billing.

Most of all, the best claim rejection prevention is having a good medical billing company to handle the work for you. We can process your claims, and fight your claim rejections. You just focus on keeping people happy and healthy.