Claim denials? Need we say more?

For behavioral health organizations, claim denials are more than just an administrative headache. They pose an ongoing problem that inhibits cash flow through your organization. Not only that, but patients can also become frustrated if they receive bills for services that they assumed were covered by their insurance and that, in many cases, they may not have the funds to pay out of pocket.

Are you tired of dealing with insurance claim denials? Do you want to get paid faster? Let’s get started with some best practices to help reduce insurance claim denial for your organization.

If you need help calculating your claim denials rate, we have a page for that.

Stop Dealing with Insurance Claim Denials and Start Getting Paid Faster

STEP ONE: MINIMIZE HUMAN ERROR

Millions of healthcare insurance claims are denied each year. All too often, those denials come, not because the services aren’t covered by the patient’s insurance, but because of human error somewhere along the way. These steps can help increase the odds that your claims will be approved.

• Always confirm the patient’s insurance at the beginning of each appointment.
• Double-check all billing codes.
• Always make sure patient billing information is accurate and complete.

Utilize the checklists below to ensure that all of these items are properly covered in your office– and that your billing specialists don’t miss any important details when filing a patient’s claim. Efficient EHR software can also help double-check that information, identify inaccuracies, and ensure that you have the correct information in place before you send that claim to the insurance company.

STEP TWO: CHECK IN WITH AND TRAIN STAFF 

When you hired your staff, you likely made sure that they had a solid understanding on code updates and procedures for your office. Over time, however, those codes and procedures may change substantially. 

• Hold or require annual training and updates.
• Update all members of staff when you institute a software or policy change.
• Check in before there’s a problem.

STEP THREE: KNOW WHAT PATIENTS’ POLICIES COVER

In order to reduce a patient’s insurance claim denials, you need to know what their policies cover–often before rendering services. Patients also need to know what their insurance will and will not cover, especially since that can determine which services they choose to pursue and which ones they forego until they have vitally needed funds in place. Ask these questions:

• What specific procedures or treatments will patients’ policies cover?
• How much coverage does each patient have?
• What is the patient’s responsibility when it comes to payment?

In addition to helping, you track the coverage offered by patients’ policies, EHR software like TenEleven can help track patients’ financial responsibilities and keep up with their deductibles and other financial obligations. It can also help track the bills you’ve sent to help avoid double-billing and ensure that patients aren’t billed unfairly.