Etactics

APRIL 13, 2023

When dealing with medical claim denial statistics, Experian Health has some great examples. For instance, according to their 2022 State of Claims Survey , 30% of health professionals say that claim denials are increasing anywhere from 10% to 15%. If you look back at our previous blogs, you can even find a few of them.

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Best Medical Billing Company | Physicians Revenue Group, Inc.

MARCH 30, 2023

Secure your claims from an intermittent refusal by accurately filling bills. We offload the exhaustive revenue stream by handling your billing responsibilities while improving claim acceptance. We have made it easier to practice your orthopedic services without the fear of outstanding claims or missed account receivables.

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Etactics

DECEMBER 21, 2021

Front-end revenue cycle processes account for half of all claim denials on average. So, what can medical billers do to cut down on front-end claim denials? The answer is simple, claim scrubbing. Claim scrubbing is tedious, especially when done manually. Although that sounds like a nice and easy process, it’s not.

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Icanotes

APRIL 13, 2021

Mistakes and errors on the claims you submit to insurance companies can delay payment or cause the company to reject your claim. To streamline the billing process and reduce the number of errors that occur, many providers work with medical clearinghouses, which review and scrub claims before submitting them to insurance.

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Etactics

OCTOBER 20, 2023

According to a KFF report , 2021 saw an increase of 17 percent in in-network claim denials. Make sure the data on the medical claim is complete, accurate, and thorough! Especially when handling denied medical claims. The last thing you want is to resubmit a claim only to have it come back rejected again.

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Etactics

JANUARY 18, 2023

Nearly 15% of all claims get denied according to AARP. This amounts to over 200 million claim rejections each day! There are ways you can avoid claim rejections and thus keep your revenue flowing. From claim scrubbing to real-time alerts on denials so you don’t have to wait weeks on insurance companies.

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Healthcare Leadership

JUNE 25, 2023

In March 2023, ProPublica published an exposé on how Cigna rejects claims without actually reading them. Personal blogs?) How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them”, ProPublica , 25 March 2023, [link] , accessed 25 June 2023 Hurt, Stacy. ie: social media? Miller, Maya.

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Etactics

FEBRUARY 10, 2023

There are between 5 and 10 percent medical claim denials on average, according to the AAFP. In 2020, across HealthCare.gov insurers, reports show that 18 percent of in-network claims resulted in claim denials. Healthcare insurance companies assign these codes to claims that are unable to process. Let’s dive in.

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Etactics

JANUARY 18, 2022

Second, insurance claim denial rates are well over 11%. That’s exactly what this blog post covers. Table of Contents Step 1: Credentialing Preparation Step 2: Credentialing Application Step 3: CPT Codes You Need to Know Step 4: Claim Submission Step 5: Post-Submission and Appeals Conclusion.

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Etactics

APRIL 11, 2023

Provide a service, submit a claim, and receive payment. The American Medical Association’s most recent study found that major payers return to up to 29% of claims with $0 payment. It also happens 7% of the time because of claim edits and 5% of the time because of other denials. However, this is costly for your practice.

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Etactics

SEPTEMBER 1, 2023

In order to begin understanding the revenue cycle, a good starting point is taking a deep dive into the healthcare claims themselves. In the modern revenue cycle process, there are two main types of claims; 835s and 837s. Let’s take a deeper look at these types of healthcare claims. But, there is more minutiae involved.

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Etactics

OCTOBER 25, 2022

Functions such as patient reminders, calculating existing patient balances, handling claim denials, and more will be at your disposal. For example, let’s take a look at claim rejections. What are some of the main reasons for a claim rejection? Outsourcing Revenue Cycle Management. I have good news for you.

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Etactics

JANUARY 11, 2022

You see, the average initial claim denial rate in Q3 of 2020 alone hit over 11%. After all, there are differences between the types of claims that hospitals submit compared to those coming from mental health facilities. That’s not to dismiss what you’re going through, misery loves company. But how do you actually solve this problem?

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Etactics

NOVEMBER 3, 2022

30% of insurance claims get denied on their first submission. Part of this is because of the complicated nature of the claim adjudication process. There’s nothing simple about the claim submission process. Every claim you submit goes through an adjudication process, regardless of which insurance company it gets submitted to.

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Etactics

SEPTEMBER 7, 2023

There were nearly 50 million denied healthcare claims in 2021. Based on the total number of in-network claims submitted, that averaged out to a 17% denial rate. In other words, healthcare claim denials are a plague that every healthcare organization has to not only deal with but also try to figure out ways to manage them.

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Etactics

MAY 19, 2023

The top concerns for claim denials are as follows: Coding 32% Medical Necessity Acute IP 30% Front-End 20% Clinical Validation Denials 18% The good news is that approximately 34% of claim denials are absolutely avoidable, with about 86% of them being potentially avoidable. But that’s only one part of the equation.

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Etactics

FEBRUARY 10, 2022

But for the sake of this blog, let’s focus on physical therapy. On average, it costs $25 to rework one of these denied claims. The codes must match the corresponding services because if they don’t, they could get rejected by the insurance company. via IBISWorld. It’s quite an extensive list. billion in revenue.

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Home Health Care

OCTOBER 2, 2023

There are companies who are making real gains with, for example, claims or things like, do I want to predict whether I should take on this referral? Well, we definitely see a lot in terms of claims processing, so reducing the error rates in claims. Is it going to be profitable? Do I have the staff to staff this?

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