How To Avoid Denials In Your Medical Billing Services
                     HOW TO AVOID DENIALS IN YOUR MEDICAL 
BILLING SERVICES?
Medical billing denials are constant headaches hitting several healthcare providers’ operational efficiency, revenue, 
and cash flows.
Numbers clearly tell the story. Did you know that the industry benchmark for medical billing denial stands at 2% 
for hospitals?
In fact, the medical practices are experiencing medical billing denials at rates that range from 5 to 10%, with an 
average of 4% for the better performers. Some medical organizations even experienced the first billing denial rate 
as high as 15-20%! For such organizations, one in every five medical claims submission must be appealed or 
reworked. However, each 0072ework costs around $25 per claim, and usually, the success rates vary between 55 
to 98% depending on the expertise and the capabilities of the denial management team.
When nothing works, write-offs can range between 1-5% of the net patient revenue. This indicates that in a 300-
bed hospital, on average, 1% write-off means $2 to $3 million a year. That’s quite a whopping amount for a 
medical organization.
The good news is that the medical practices can avoid the majority of billing denials. Undoubtedly, these can never 
be brought down to zero, but reducing them by even a fraction of a percentage can substantially impact the 
bottom line of your business. The best approach is to understand different causes of denials, pinpoint the common 
billing challenges, and initiate the steps to avoid them.
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[email protected]         https://www.247medicalbillingservices.com/          888-502-0537
[email protected]         https://www.247medicalbillingservices.com/          888-502-0537
Track Each Claim
You have to ensure that none of your claims are getting lost 
in your practice management system. Track all the claims 
meticulously. If you find any discrepancy, you should 
implement a more comprehensive process to track the 
status of the claims through the entire revenue cycle.
In several cases, the claims slip through the cracks as they 
are not handled quickly by your team. You have to ensure 
that your coders are coding each patient encounter on the 
same day or, at most, one day later from the service date. 
Moreover, upgrade your technology to a system to make 
sure of the scrubs, submissions, and monitoring of the 
claims with minimal employee efforts.
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Pinpoint the “Why” in your Claim Denials
Unless you clearly understand why your claims are 
getting denied, you can’t bring down your denial rates. 
Start reviewing all your claim denial notices from a 
defined time- say, two or six months and figure out 
associated reasons for such denials.
Usually, a few of the most common reasons for medical 
denials include incorrect registrations, verification, or 
identification of the patients or their treatment or 
diagnosis codes. The best part of these denials is that 
they can be traced back to the responsible person. Figure 
out the patterns and have a word with the employees 
who are responsible for the repetitive offense.
[email protected]             https://www.247medicalbillingservices.com/        888-502-0537
Follow Up in Time
Are you aware that only a small percentage of medical practices 
actually make an effort to follow up on the claim denials and 
resubmit or appeal the corrected claims? If you don’t fall under this 
subset, you are saving insurance payers money at your own cost!
Most denials can be resubmitted after correction within a given 
time slot that depends from payer to payer. Look for the window as 
per your major insurance payers and ensure that it never missed 
out. Better yet, make it your billing team’s top priority to follow up 
on each denial case in 5-10 days to submit the corrected or appeal 
claims at the right time, if deemed appropriate.
[email protected]             https://www.247medicalbillingservices.com/        888-502-0537
Automate Eligibility Checking
Ineligibility is another major concern for denials and rejections for few 
medical practices. Yet, most medical practices still handle the eligibility 
checks of the patients in an unsophisticated and unstructured way. 
They often choose to make last-minute calls to the payers just ahead of 
the patient appointment or after the services have been rendered.
Neglecting the eligibility checks accounts for a disservice to your 
medical practice and patients. Instead, invest in a cost-effective 
software tool that can check the eligibility in an automated pre-
scheduled manner. Alternatively, you can choose to outsource the 
verification and other revenue cycle procedures to a trusted and 
reputed medical billing service that can handle the task professionally 
and efficiently.
[email protected]             https://www.247medicalbillingservices.com/        888-502-0537
Revisit Your Medical Processes for EOBs & Remits
How much time do you take to incorporate the necessary information from the remits into your 
billing process? Do you still rely on the paper explanation of benefits (EOBs)? How long do they 
linger on your billing and coding team’s desks before reconciling with your latest technology?
You can’t avoid a denial until you know its existence! If there are constant procedural delays, you 
miss out on the opportunities for timely claims re-submissions and follow-ups. Instead, it is the 
right time to switch to electronic EOBs and streamlining the remit management system so that 
you can eliminate human errors, thereby saving precious time.
Conclusion
Avoiding any of the reasons for denials occurrence is key for ensuring optimal insurance denial 
management in medical billing. But it takes a lot of effort for a busy medical practice to keep up 
with these latest medical billing procedures. The best alternative is to follow the best denial 
management tactics or partner with an experienced 24/7 Medical Billing Services team. They can 
often ensure better insurance denial management with up-to-date collections. Contact us today at 
+1-888-502-0537 to leverage our expertise and experience to transform your healthcare practice.
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[email protected]             https://www.247medicalbillingservices.com/        888-502-0537
ABOUT US
• We are a medical billing company that offers ‘24/7 Medical Billing Services’ and 
support physicians, hospitals, medical institutions and group practices with our end to 
end medical billing solutions. We help you earn more revenue with our quick and 
affordable services. Our customized Revenue Cycle Management (RCM) solutions 
allow physicians to attract additional revenue and reduce administrative burden or 
losses.
• Our company was founded in 2005 and is now a leading organization of highly 
motivated and certified coders & billers in the US medical billing industry. Our current 
employee strength is 500+ and we have ambitious plans to grow more rapidly.
• As a leading Medical Billing Outsourcing Company we take care of the complete setup 
& enrolment in about one to four weeks time depending on the complexity of the 
project. We have certified trainers with 10+ years of experience to train the 
newcomers so they can get acquainted with the specialty jargons & stay updated with 
the recent coding developments.
[email protected]             https://www.247medicalbillingservices.com/       888-502-0537
CONTACT US
24/7 Medical Billing Services
16192 Coastal Hwy,
Lewes, DE – 19958
USA
Phone no : 
+1 888-502-0537
Email Address :
[email protected] 
[email protected]             https://www.247medicalbillingservices.com/       888-502-0537