What is the cost of Denied Claims?

While you spend the majority of your time interacting with patients, submitting claims might seem burdensome. Many times, amidst your busy schedule you may be unable to accurately submit an insurance claim. A minute error may end up impacting medical practice adversely.

U.S health care reached $3.8 trillion in 2019, at around 15 percent of the nation’s GDP. After re-appeal nationally, denial/rejection management costs hospitals roughly $262 billion per year, creating significant cash-flow issues with their revenue cycle management.

cost of denied claims

Claim rejections are one of the biggest threats to cash flow and the overall medical practices’ revenues. Even the most experienced and well-trained individual can make minor mistakes while submitting a claim. Errors however small they may be can lead to rejections and a big loss of revenue. Claims once rejected can be re-submitted after correcting the errors.

Submitting the claims again does involve additional operations and processing costs. Studies suggest that only 63% of initially denied claims are processed later on which means around 27% of claims will be foregone forever leading to a direct loss of revenue. Similar studies suggest that it costs $118 per claim on average to rework and re-submit the claims.

Here are a few tips that can help avoid the most common billing related errors, and get the claim processed in one go:

• Track and analyze trends in payers, denials, and rejections. Catalog each trend and decide the right action just as quickly. A checklist for data and documentation needed can help identify such problems before you submit the claim.
• Train your finance and billing staff (and regularly updated with the latest happenings) to respond quickly to rejections and handle denials.
• A healthy relationship and frequent discussion with insurance can weed out potential glitches
• Outsource the medical billing operations that can be efficiently handled off-site. An automated software or external vendors can analyze, and flag off potential denials before they happen. Choosing to work with an outsourced medical billing services firm acts as a safety check to quickly resolve rejection and keep the bills on track.

Medical claim denials and rejections are some of the most significant challenges faced by a physician’s practice today. These lower the practice’s revenues and the billing department’s efficiency. Medical billing services firms are experienced in submitting claims accurately, before time, and helping minimize revenue leakages. Practices that choose to outsource billing to professional medical billing services firms can save effort, time, and money.

Atlantic RCM is one of the leading multi-specialty medical billing companies in USA that serves 25+ major medical billing specialties. Our experts work across your practice in billing, collections and account receivables management, to help you succeed.

Get in touch with the leading medical billing outsourcing company to learn more. Call us at (469) 501-1500 or write to us Info@atlanticrcm.com