Submitting clean claims is a constant struggle for every medical practice and you might have hired a financial team or depend on a robust Revenue Cycle Management (RCM) Software Solution to make sure you don’t lose out on money. Medical claim denials cost medical practices a substantial amount which can harm the revenue earned. Reported by the Healthcare Financial Management Association (HFMA) that out of $3 trillion in total claims submitted by healthcare organizations, $262 billion are denied. This means you need to empower your staff to avoid claims being rejected to maintain and increase revenue.
What should be your goal?
Your practice should aim to submit a clean claim in the first attempt to avoid the costs associated with claim resubmission which includes the cost of the denied claim and also the cost paid to staff members to work again for the claim to be submitted without any errors.
The Hidden Cost of Denied Claims – Task Switching Cost
Task switching cost is when medical practices reassign already burdened staff members to work on resubmission of claims. Task switching is like multitasking and new studies show the human brain is not designed for switching and back and forth between several tasks. It drains the mental energy and also results in inefficiencies which can cost your practice. The increased work pressure due to task switching can result in administrative burnout which can also lead to a higher employee turnover rate.
Improving Claims Management Process
The value of effectively scrubbed claims cannot be underestimated, as it can improve the financial health of your medical practice. By ensuring an efficient claims management process through outsourcing your RCM processes or maintaining an in-house team you can improve productivity and also increase your practice revenue.
Main Reasons for Denied Claims
To avoid denied claims you should be well aware of the main reasons for common denials. Here’s why a claim can be denied;
- Missing or incomplete information
- Incorrect patient information
- Wrong ICD Coding
- Not filed on time
- Claim is non-specific
- Claim is duplicate
Final Takeaway
Administrative teams must work together to identify the underlying cause of a claim being denied. The services of a billing expert can be taken to reduce billing errors that happen repeatedly. By deploying a robust RCM Software system practices can avoid common bottlenecks such as improper monitoring, billing errors, and slower billing processes to make sure your daily collections are optimized.
