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Claims Processing: How to Avoid Claim Denials

Medical Claims Denial appeals formThe best healthcare practices know that managing claims and avoiding unnecessary claim denials is a crucial part of the business. Errors, oversights, and delays in processing can cause more  than you might think. To have an immediate impact on your business make improvements in these three areas.

All claims must be legible. Even claims printed electronically can get messy, smudged, or blurred from printers and scanners which can create a huge problem for payers. Payers must be able to read and scan claims into their system immediately upon receipt for you to get paid quickly.

Make sure all claims are detailed and specific about the care received by the patient. It’s uncommon for claims missing facts such as the date of the accident, emergency or onset of the medical condition to be denied. It’s important to answer each and every question on a medical claims form.

File all claims in a timely manner. This can get complicated to manage because each insurance carrier operates under its own guidelines and payment schedule. Carriers will deny claims that are simply not received within their payment window stipulated. When you are working with a number of different insurance carriers, you can quickly see the benefit of working with a medical claims processor like Apex EDI.  

Apex EDI works with providers to carefully manage insurance claims and make sure all filing deadlines are met for multiple payers. This allows you to get paid fast and stay focused on providing excellent patient care. Contact us at Apex EDI for a free demonstration today.

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