American Business Systems works to improve the medical billing process to help practices reduce their losses. One of the top issues surrounds claim denials, which often stem from coding and medical billing issues. The ABS Business Package is one solution for billing process optimization, but it’s still helpful to look into why denials have become a widespread problem in the first place.
For example, a 2021 Harmony Healthcare survey made waves when it revealed that national hospital claim denials had risen over 20 percent, representing a loss of around $5 million. On top of that, HBMA reported that an estimated 60 percent of returned claims aren't even resubmitted. If they were, reworking or appealing just one claim denial would still cost a packet for individual patients and around seven times more than that for practices and hospitals.
Below are five ways American Business Systems suggests that medical practices and hospitals save time and money on avoidable denials of claims.
#1 Verify Eligibility
The first step in preventing claim denials is verifying a patient's eligibility. Does the patient qualify for the insurance? Is there coverage for their medical condition?
Asking questions from the beginning circumvents automatic denial or the claim being thrown out as unqualified.
#2 Provide Specific Details
Insurance providers assess needs based on assumptions about the patient, medical condition, and available treatments. Medical record resources from companies like American Business Systems help practices provide more accurate details about the patient's condition and their potential treatment. That way, the claim is more likely to go through.
#3 Act Quickly
If there’s a denial, it’s always better to respond quickly by appealing or resubmitting. Prompt responses keep the process moving. It accelerates the claims resolution process, which keeps the revenue cycle going as it should.
#4 Keep the Process Organized
Aside from revenue losses, denied healthcare claims hurt practice reputation. A team like American Business Systems provides structured systems for handling denied or unresolved claims efficiently so that practices can maintain their hard-earned credibility.
#5 Work As a Team
In many cases, navigating the claims process requires some help. A collaborative effort with billing experts like American Business Systems make resolving claim denials far more effective.
About American Business Systems
Patrick and Linda Phillips launched American Business Systems in 1987 with the mission to help practices streamline efficiency, including in medical billing. The company is now the largest network of Certified Medical Revenue Managers helping medical practice owners enact successful medical billing. For more information, contact American Business Systems via the online form or at 866-565-8413.
