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Medical Billing Denial Management

Medical Billing Denial Management

Denied medical claims have been reported as representing 90% of missed revenue opportunities in medical practices. In total, an estimated $262 billion in medical claims are initially denied each year. Out of all the claims denied, research shows up to 65% of them are never reworked. Over half! That is hundreds of thousands of dollars lost! And more shocking than that, 90% of them were avoidable.

On top of potentially losing the revenue from the service, it costs to rework a claim – $25 each. If you have 10 claims a week denied, that is $250 a week, $1,000 a month, $12,000 or more a year spent trying to get reimbursement for services rendered from payers. Not to mention the time spent by staff members dealing with the appeals.

The reality is denials are going to happen, but at Billed Right’s Denial Management Services in Florida works hard to minimize the number of denials and to deal with the ones that do happen.  Our team will appeal those denials, even to three levels.

How do we do it?

  • We will contact the insurance carrier to determine the reason for non-payment and take the appropriate action based on a pre-defined process.
  • We may follow up, complete an appeal, and add all supporting documentation, submitted, in your software, for transparency, or we may ask you additional questions to help support our appeal process.
  • Most insurance carriers are required to pay the claim or provide a denial in writing within 30 days of receipt. Using our proactive approach to handling denials, we can improve your denials and therefore improve your days In AR and reduce it to the industry standard.

 

Having an experienced revenue cycle management team on your side can help to eliminate many denials from happening in the first place. With the entire revenue cycle covered, partnering with Billed Right’s Denial Management Services in Florida can help you submit clean claims that go through the first time, reducing denials and the cost and frustration that goes with them.