Power Your Practice

The Medical Group Management Association (MGMA) found that better-performing medical groups average just a 4% claims denial rate. Is your practice’s denial rate above four percent? If it is, you probably need to stop blaming your payers for those denials and start looking inward at your office’s processes.

One major problem medical billers encounter is when claims are denied for timely filing because each insurance carrier has its own guidelines for filing claims in a timely fashion. Some are as short as 30 days and some can be as long as two years. It is important to follow these guidelines or your claims [...]

One of the most important parts of billing is handling denials. Thousands of dollars a year can be lost in providers’ offices that don’t handle denials. In fact, I saw a statistic once that said 47% of denied claims don’t ever get appealed. That is outrageous! We find that there are three reasons that denials [...]

A recent report from the American Medical Association (AMA) provides some shocking numbers on the cost of inaccurate health insurance claim payments. It’s not surprising that patients and physicians are frustrated by the high cost of health care due to claim-processing errors by insurance companies that waste billions of dollars every year.

For physician practices and medical billers, there’s nothing more frustrating than a denied claim. The work was done but, through some technicality or minor coding error, the payer refuses to pay. Practices must resubmit their claims with the hope that they corrected the problem and can now get the money they are owed. Even if [...]