The Critical Importance of Denied Claims Follow-up

Are denied claims costing your practice money?

The Impact of Inaccurate Claim Submissions

You and your staff have put in long hours delivering top-notch care to your patients. However, if your medical billing staff isn’t putting in that same diligent effort, you could be losing significant revenue due to inaccurate claim submissions leading to denials. Perhaps even more importantly, lack of follow-up to get those claims corrected and successfully resubmitted also eats into your bottom line.

The Time Investment in Denied Claims

The billing staff at a typical practice spends nearly 36% of their time working denied claims and appeals. Because appealing payers’ decisions is quite labor intensive, many practices try to take shortcuts. While understandable, failing to follow through means walking away from reimbursement your practice legitimately earned.

Common Reasons for Claim Denials

Experts estimate up to 30% of initial claim submissions contain errors leading to denials. Common reasons include insufficient documentation, coding problems, denial of eligibility, duplication, and timely filing errors. Without correction and re-submission, reimbursement for those services never materializes.

Best Practices for Denied Claims Follow-up

Best practices dictate denied claims follow-up should happen weekly. Staff should review EOBs to identify denials, then verify each claim’s accuracy. Valid claims meeting requirements need re-submission using proper appeal codes and attachments. Monitoring should continue until finalized as paid or written off once all appeal options are exhausted.

The Financial Impact of Unaddressed Denials

As revenue cuts further squeeze margins, leaving denials unaddressed erodes cash flow. Payers count on a lack of rigorous follow-up—don’t let them off the hook. With denied claims follow-up producing up to a 500% ROI, practices that dedicate sufficient resources to the task reap big rewards. It takes commitment, but with so much revenue at stake, getting denials corrected is truly worth the effort.

Considering a Dedicated Billing Service

If your practice is falling behind on following up on denied claims, maybe it is time to consider partnering with a dedicated billing service that can take this critical task off your plate. Please contact us for more info and a free quote.