It is essential to understand the claims that are denied. The healthcare providers are not efficient enough in handling the claims that are denied. Therefore, it becomes necessary to identify the income lost and improve the process of medical claim management service. This article provides the Denial Management tips to process denied claims as well as to improve the overall process.

Tracking all Claims:

It is important to track all the claims. Many healthcare providers miss to track and sometimes claims fall apart and misplace over a period of time. This is basically because of the lack of people to keep a track of the claims that have been submitted. However, if the process is used efficiently that will help the staff to track the denials, there is a less chance of getting the claims misplaced or lost.

Understand the system:

Check all the denial claims, figure out what caused the denial of claim. There could be one potential and common cause that may have led to many denials. Identify the cause and take proactive measures to avoid the denial of claims. This will definitely save time, effort, and money in the entire process.

Turnaround Time for correcting Denials:

Ensure that all the denials are checked and corrected within a week. If a claim is retuned due to incorrect submission, it needs to be corrected and resubmitted within a week. By doing so, all the denials stand on top priority and will not be lost, forgotten and misplaced. So, you must remember that if the denial claims are not handled for a longer time, you have to wait for your money. Also, most of the health insurance providers keep a time limit to address the claims that are denied.

Successes and Failures documentation:

The denial management healthcare system will also provide a documentation which clearly shows the efficiency of the methods used to claim money from the denials. As such there is no perfect or a fool proof system per se, but using this kind of system would rule out ineffective methods.

By following the simple Denial Management tips mentioned here, any little improvement will also pave way to a significant difference in the cash flow for the healthcare facility as well as better management of the denials and an improved business too.

Chirag Patel
VP - Corporate Communications
chiragb@promantra.us
Phone: +1-732-414-3678