Ensure insurance coverage and eligibility & error-free claim submission to minimize denials rate, claim rejections with healthy cash flow.

1. Tips to Reduce Denials
Rate & Claim Rejections
and Increase Practice
Revenue
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2. • Reducing denials rate and claim rejections
are the most ideal approach to ensure faster
payment.
• A rejected claim with mistakes impedes the
payment cycle, affecting your practice’s
revenue flow .
• Ensuring cleaner claims submission is the
best approach to keep away from
unnecessary claim rejections, denials and
low payments.
• Analyze your billing process to track and
monitor the most common reasons for claim
rejections.
Introduction
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3. • If there is a sudden uptick in denials and rejections,
you should set aside the effort to survey your billing
process .
• You may find that most of the claim denials are
originating from one specific insurer or a specific
diagnosis code prompts more rejections.
• Revealing the top reasons behind denials can help
you rapidly improve the clean claims rate.
• A minor change in insurer’s prerequisites could be
liable to an increased rejected claims.
• Let us talk about how to submit clean claims to
reduce denials rate & claim rejections through proper
denial management.
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4. • Before providing service, the front office commits to check insurance coverage and
benefits eligibility. After completing the verification, the clean claim is submitted to
the payers, this process reduces the chances of denials In specific cases, it might be
obligatory to get a referral or authorization number as these claims may get denied
without a substantial one.
• Authorization regularly is dynamic over a particular date and may get terminated if
not utilized during that time. A few authorizations cover a timeframe as well as a
predetermined number of treatments or visits.
Ensure Insurance Coverage and Eligibility
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5. Nonetheless, note that getting earlier
approval is as yet not an assurance of
payment. The submitted claim must
satisfy the accompanying conditions:
 It must be upheld by medical necessity
 It should be filed by the provider
mentioned in the referral
 It should be filed within timely filing
prerequisites
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6. • Applying creative trend-setting innovation empowers providers to build revenue
productivity and accuracy.
• AI directs investigation to recognize the root cause and ensure error-free claims
from the front end to avoid denials.
• You can track, measure and report on trends by physicians and payers. This
information will assist you to analyze denial trends, figure out what assets are
expected to execute solutions and track & report progress.
Use AI to Manage Denials
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7. • Medical billing rules and guidelines are continually changing, requiring doctors and
administrators to invest time and cash on proceeding with instruction, directly
affecting the income and benefits of the practice.
• There are a few codes that are stopped every year, there are a few different codes
which are acquainted every year with reflecting regularly performed methods. Our
medical billing company stays on top with current rules and regulations.
Stay Current with Payer Requirements
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8. • Prioritizing denials during the
insurance follow up and denials
will be worked within 48 hours.
• A Few out of every odd denial
should be appealed. A few denials
require dispute/appeal with the
payer. For that, we defined the
dispute strategy clearly; what is
worthy of dispute & acceptable.
Outsourcing is the Best Choice
For healthy cash flow, you have
to outsource your medical
billing to a medical billing
company that has an effective
denial management team. We use
effective strategies to handle your
denials such as,
• To increase the success rate of
appeal, we use a standard appeal
template with approved standard
verbiage.
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9. About us
• MGSI offers proficient medical billing and coding service to ensure
your practice revenue cycle efficiency.
• We will assist you to resolve issues with denials and rejections.
• Become a partner with us and learn how we enable your practice to
oversee claim denials. To know more about our services: visit us
at www.mgsionline.com

10. You can reach us at:
877-896-6474
info@mgsionline.com
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Any questions?
Thanks!