{"id":8827,"date":"2013-06-05T17:32:24","date_gmt":"2013-06-05T21:32:24","guid":{"rendered":"http:\/\/blog.carecloud.com\/?p=8827"},"modified":"2013-06-05T17:32:24","modified_gmt":"2013-06-05T21:32:24","slug":"quick-fixes-common-insurance-claim-denial","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/quick-fixes-common-insurance-claim-denial\/","title":{"rendered":"2 Quick Fixes for a Common Insurance Claim Denial"},"content":{"rendered":"

One of the most common reasons for claim denials<\/a> given by payers is that a patient lacks insurance coverage or has had their coverage terminated<\/strong>.<\/p>\n

When receiving this particular claim denial, all options need to be exhausted by the provider to determine if a clean claim can be resubmitted, so payment can be collected. Luckily, there are a couple of paths you can take to quickly reveal whether the claim is ready for a successful appeal.<\/p>\n

Check for Payer Errors<\/strong>
\nJust as medical billers aren\u2019t perfect, neither are payers. This holds true for large payers such as Blue Cross and Blue Shield as with smaller payers as well.<\/p>\n

If possible, search through the payer\u2019s website to locate a patient\u2019s file and find out if their insurance ID number has changed<\/strong>. If that\u2019s the case, the provider portal should give you the patient\u2019s correct ID number, so you can resubmit a more accurate claim.<\/p>\n

Also, check the patient\u2019s claim history. If the payer has made payments for that patient before and after your date of the service, reach out to the payer to question the claim denial.<\/p>\n

Contact the Patient<\/strong>
\nIn the event, the denial appears to be correct or you can\u2019t easily locate the necessary information, it is time to get in touch with the patient.<\/p>\n

One non-intrusive method is to mail a statement of charges to the patient, stating that their insurance was denied due to a lack of coverage. Once a bill is received, the patient is likely to contact your practice and their insurance company to inquire about the charges.<\/p>\n

Of course, you can always reach out to them directly by phone or email. This can be more cost and time-efficient than sending out bills<\/strong>, which will likely be disputed.<\/p>\n

In certain cases, the patient recently changed their insurance provider and forgot to notify your practice. Once the updated information is obtained, the claim can be resubmitted to the correct payer.<\/p>\n

It\u2019s worth noting that much of the fuss over this common claim denial can be bypassed with a quality PM system<\/strong> that checks patient eligibility prior to claim submittal. Even when the aforementioned quick fixes are successful, nothing beats submitting a perfect claim the first time.<\/p>\n

If you\u2019d like to find out how our\u00a0web-based PM system can help you avoid claim denials, please contact us at 1-877-342-7517 or\u00a0hello@carecloud.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

One of the most common reasons for claim denials given by payers is that a patient lacks insurance coverage or has had their coverage terminated. When receiving this particular claim denial, all options need to be exhausted by the provider to determine if a clean claim can be resubmitted, so payment can be collected. Luckily, […]<\/p>\n","protected":false},"author":1,"featured_media":32786,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[39],"class_list":["post-8827","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revenue","tag-revenue"],"yoast_head":"\nTwo Quick Fixes for a Common Insurance Claim Denial<\/title>\n<meta name=\"description\" content=\"When receiving an insurance claim denial stating the patient lacks coverage, there are two quick solutions to get a claim processed cleanly.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/carecloud.com\/continuum\/quick-fixes-common-insurance-claim-denial\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" 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