2. Avoid Denials for your Pathology Billing with these
Proven Methodologies
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The old saying "the best defense is a good offense" has been applied
in a variety of fields.
To achieve the maximum first pass acceptance ratio, you must be
cautious when filing insurance claims. Even if you believe that
everything was submitted correctly, there are a plethora of reasons for
insurance claims to be denied.
Lack of specificity in code usage, incorrect application of modifiers,
and a variety of other factors may result in a lower percentage but
outweigh the total charges submitted.
According to the American Medical Association, insurers deny
between 1.38 percent and 5.07 percent of claims. Even the best-
performing practitioners have a 5% denial rate as per the Medical
Group Management Association.
Failure to work on insurer denials results in revenue loss for your
medical practice. Though it's easy to point the finger at someone else,
it's critical for a pathologist to develop and optimize proven techniques
for getting claims paid.
3. Avoid Denials for your Pathology Billing with these
Proven Methodologies
https://www.247medicalbillingservices.com | +1 888-502-0537
Let’s discuss some of the proven methodologies that can help you to
avoid denials in your pathology billing:
Determine the root causes of pathology billing denials
According to a 2020 Change Healthcare study, the majority of claim
denials for the fourth consecutive year were due to issues with patient
eligibility or registration for the provided services. Denials for patients
who have used up their maximum available benefits, issues with
benefits coordination, and plan failure to cover the service in question
are all examples of this. Examine the data for your pathologist's
practice claim denials to see where the majority of issues arise. Many
issues can be avoided by automating processing in this area,
especially when combined with a robust staff education program.
4. Avoid Denials for your Pathology Billing with these
Proven Methodologies
https://www.247medicalbillingservices.com | +1 888-502-0537
Begin with the biggest issue
Stopping at just one source of frequent claim denials in your practice
could have a significant impact on the revenue cycle. After collecting
information about the root cause of submission denials, crunch the
numbers to determine which issue has the greatest impact on practice
revenue. You can use analytics to identify denial trends by payer,
procedure, department, and provider. Invest your resources in
solutions that address the most significant sources of revenue loss
before addressing less urgent pathology billing and coding issues.
Use technology to your advantage
This type of software can review claims and flag those that are likely
to be denied, allowing potential issues to be addressed before sending
the reimbursement request. While implementing high-tech tools has a
cost, most pathology practices that go this route find that they
significantly increase profits while decreasing the resources dedicated
to pathology billing and claims.
5. Avoid Denials for your Pathology Billing with these
Proven Methodologies
Establish an appeals procedure
In approximately 65 percent of cases, pathology billing providers fail
to appeal denied claims, effectively leaving money on the table.
Emphasize eligibility verification
It is also one of the most expensive pathology billing denials
because the insurance company rejects the entire claim rather than
just one code. Staff members should be trained to verify patient
demographic and insurance information at every visit, regardless of
how recently the person received care. Emphasize the significance
of gathering and verifying accurate patient data. When in doubt
about eligibility based on patient-provided information, always check
with the insurance provider directly before administering the
treatment or service.
https://www.247medicalbillingservices.com | +1 888-502-0537
6. Avoid Denials for your Pathology Billing with these
Proven Methodologies
Conclusion:
Pathology claim denial is a major source of frustration for pathology
billing staff and has a significant impact on your practice's cash flow.
Make sure to respond to denials as soon as possible to determine
what action is required, and always keep the patient's best interests
in mind. Most importantly, do not allow denials to pile up. You can
also get connected with the 24/7 Medical Billing Services as your
outsourced pathology billing partner to control the denials as and
when they arise.
https://www.247medicalbillingservices.com | +1 888-502-0537
7. Avoid Denials for your Pathology Billing with these
Proven Methodologies
About 24/7 Medical Billing Services:
24/7 Medical Billing Services is the nation’s leading medical billing
service provider catering services to more than 43 specialties across
the entire 50 states. You can rely on us for end-to-end revenue cycle
management. We guarantee up to 10-20% increase in the revenue
with cost reduction of your practice for up to 50%.
Media Contact:
Hari Sudan,
24/7 Medical Billing Services,
16192 Coastal Hwy, Lewes, DE – 19958
Tel: + 1 -888-502-0537
Email - info@247medicalbillingservices.com
https://www.247medicalbillingservices.com | +1 888-502-0537
