Denial Management in Medical billing services is the most arduous process and is often overlooked by physicians and medical practices due to their busy schedules and primary focus on patient care; eventually, the claim denials get accumulated causing distress to the entire process and financial grounds of the medical practice if not taken care on time. Therefore it is essential for every medical practice to have a proper denial management system in place to protect their claims quality and revenue.
Denial Management is not only about working on the denied claims but also about creating a smooth working process by improving process quality, focusing efforts towards uncollected revenue and maximizing the collection, and also preventing and lowering denial percentage by identifying repeated denial reasons and educating respective claims processing team to get them corrected. With MGSI as your Medical Billing and Denial Management Partner, you can experience the difference and witness increased collections and improved claim quality.
Denial Management Process in MGSI:
Claims denials occur for various reasons, while the focus should be on reducing the denial percentage by increased first pass ratio; denials cannot be ignored completely as claim denials are inevitable which necessitates the need for an efficient and timely Denial Management process. The denial management team should be experienced enough to identify the cause of claim denial and rework within the turn-around time (TAT) to get them processed successfully and profitably.
- The first and foremost step towards denial management is to identify claim denials. The proper and efficient claims tracking system is mandatory to ensure the claim denials are identified and re-processed.
- After Identifying claim denials, it is the responsibility of the denial management team to do a complete analysis of the claim to identify the reason for claim denial and fix them to re-submit the claim again with the insurance company
- Appeals are part of the denial management process where the denial management team needs to provide supporting document to justify for their appeal and follow up to get the reimbursement.
- Constant follow-up with insurance companies is necessary to ensure the appeals are processed in a timely manner
- Denial management team also helps prevent claim denials by educating the medical billing and coding team with their findings on denial reason and thereby helping cleaner claims to be processed.
MGSI has been serving over 600 physicians across the nation with complete Revenue Cycle Management Services for various specialties and has been the forerunner in the industry by providing Medical billing services for over 29 years. Leveraging our Denial management expertise can bring positive impact to your practice and monthly revenue.