Five Helpful Denials Management Strategies from PracticeForces
PracticeForces is a leader in providing comprehensive revenue management services for medical practices. Since 2003, PracticeForces has provided its dynamic Medical Billing Management Services to various physician practices. As a result, PracticeForces sets itself apart from other Florida medical billing companies.
Instead of only selling EMR and medical billing software, PracticeForces seeks to work with a practice’s infrastructure to boost revenues, help with prior authorization, reduce denials, and streamline a practice’s overall functions. In 2018, their company received the USF Fast 56 Award for being the fastest-growing Revenue Cycle Management business, and they’re here today to share five helpful denial management strategies.
#1: Keep Detailed Records of Successes and Failures
Denials management includes knowing which methods and strategies work and which ones don't. Unfortunately, with so many variables like various health insurance plans, not one solution fits all. However, having a detailed record of your successes and failures will allow you to make better decisions in the future and adjust your current methods. Also, see if a common problem exists across your denied claims. This method allows you to tackle any issue at its source.
#2: Thoroughly Track Every Claim Made or Denied
Keeping track of every claim is difficult for some healthcare providers because they don't have enough people. A proper denial management strategy requires you and your team to thoroughly track every claim so that none of them fall through the cracks.
#3: Handle Denied Claims Within a Week
An incorrectly submitted claim either gets denied or returned. When this happens, you and your team must resolve the issue(s) and resubmit the claim. Your team should always prioritize these claims and resolve to resubmit them within a week. Many health insurance companies have specific deadlines for resubmitting denied claims, making a week deadline even more crucial.
#4: Always Appeal a Case When There’s Documentation Validating the Original Coding
There are cases where it makes sense to accept a denied claim. However, you'll want to appeal the denied claim if you have documentation supporting the original coding. When appealing the denied claim, make sure to employ the following strategies:
- Have your denials management team work alongside coding experts to write the appeal
- Clearly state the reason behind the claim’s denial from the original document
- Keep your appeal letter factual, specific to the situation, and concise
- Include any records or reports that support your appeal
- Include official reporting and coding guidelines and the credentials of every team member working on the appeal process
- Request a response deadline from the payer
#5: Outsource Your Denials Management to PracticeForces
The denials management process requires time, money, and energy. By outsourcing this process to PracticeForces, you and your practice can focus on other essential areas.
Contact PracticeForces to learn more about their denials management services in Clearwater, Florida. You can reach their office by calling (727)732-2831 to hear more about their services or call their patient line at (727) 771-1300!
Want to learn more about the reasons for claim denials in medical billing? Could you read about it here?
