‘Denial’ is something that we least expect when we are actually expecting a certainty, and when you get it for a claimable medical bill, the pain is even more and frustrating. Fixing denials are a crucial part of processing medical bills and hitting the lowest medical denials is certainly a credible position to be in. This is exactly where Rannsolve denial management services for medical billing will help you out.
Key Reasons for Denials
There are many issues that can arise leading to the denials in enrollment and credentialing. Rannsolve has a separate physician enrollment and credentialing service which can effectively take care of physicians’ denial management. Some of the main reasons for denials in medical billing are:
- Incorrect patient information: This could be as simple as a misspelled name to grave differences like wrong information passed on by the patient.
- Invalid medical code: This is a major reason for denial, often codes are wrongly entered leading to a mismatch between codes and medication used.
- Documentation: Lack of documentation support or counter-acting documents.
- Clubbed or non-covered ailments: This is why it is important to talk to the patient’s insurer before conducting the treatment so that you and the patient have a clear idea of the type of claims receivable.
- Pre-authorization or Pre-certification cases