When a company refuses to provide a service that is requested by the medical billing company or the payer itself due to some error, it is known as claim denial. It is reversible by fixing the errors mentioned by the insurance service provider. However, it is different than claim rejection because the rejected claims cannot the fixed.

Claim denials have increased by 23% in comparison to the last four years. Claim denials are costly because it takes double the expenses to redo all the work done previously. To avoid claim denial, we have to keep our denial management strategies strong and up to the point. The error can be of many kinds, including false or misinformation. We, here at Ibex Medical Billing can give you a 94% success rate in denial management.

Now let’s have a look at our strategies:

Our  denial management process not only clear the errors and make the claim accurate, it also helps you to avoid any future management problems. Our professional denial management team keeps a check on the reasoning denial codes and services. They correct and keep track of all the information, registration, services and billing on both sides. This process is commonly called as IMMP or Identify, Mange, Monitor and Prevent process.

1. Identify:

   We identify the reason or root cause of the denied claim for the first step. Mostly the insurance companies already mention the reason of claim denial. If the insurance company indicates the reason, it is called as CARC or Claim Adjustment Reason Codes.  But if it’s not mentioned, our team members manually identify the reason behind it. Professional and skilled member is required to rule out the actual cause.

2. Manage:

   It’s time to manage the identified cause of claim denial. Some actions are performed by our team to ensure the smooth process of claim.

   • Firstly, we add the denied claim directly into our task list using automated tools. It helps to quickly access them and start the resolving process.
   • Then we sort our work out. We use specialized soft wares to separate the work on the basis of time, reason and quantity etc. everyone starts working on their part efficiently. Like the famous saying, team work makes the dream work.
   • A customary action plan for every denial is made for the third step. Each error is thoroughly monitored and a management plan is made and worked on.
   • A checklist of all the previous errors are made and added to the documentation to avoid any further errors. That’s why, we are providing a nearly perfect claim management rate with all of our experience.
3. Monitor:

   We monitor our denial management process strictly to keep everything on track. It helps to avoid any future claim denials and accurate submissions. Everything is documented under the categories of date, time, type, reason, technologies, management etc.

4. Prevent:

   With the help of monitored data, our team starts a prevention operation. The team keeps a check on our monitored history to prevent any more claim denials. Different teams are assigned different tasks to correct errors for a quick and smooth workflow. It saves us from possible revenue loss.

   Head on to our website and book your free appointment now.