Helping Medical Practices Increase Revenue

The global Covid-19 pandemic has gone far beyond thousands of infections and deaths, it’s resulted in the closure of businesses and job losses on a scale that hasn’t been seen in the U.S. in recent history. Unfortunately, job losses that have come as a result of Covid-19 have resulted in many individuals losing benefits, including their health insurance.

Treating uninsured patients always presents challenges for medical practices, but the sudden increase in the number of uninsured individuals creates additional difficulties for physicians who may already be struggling financially as a result of the pandemic. 

Claim denials are one of the most significant barriers to efficient revenue cycle management. Denials not only require additional resources and time for reprocessing, but they also slow down your practice’s cash flow by delaying payment. Statistics show that around $262 billion in medical claims get denied initially, but even worse, more than 60% of those claims do not get reworked, which means that’s a lot of money down the drain.

The Centers for Medicare & Medicaid Services finalized their Fee Schedule included some pretty significant changes to reimbursement and documentation requirements for evaluation and management also known as E&M office visits. But, most of the changes won’t be taking effect until Jan 1, 2021, which means the time to begin preparing is now.

In these unprecedented times, we have been digging into some of the most common denial reason codes to shed some light on solutions that help your practice avoid costly denials. Unfortunately, claims denials are common, and they have a significant impact on your bottom line. We’ve rounded up five most common denial reason codes and offered helpful tips on how to solve them to reduce the number of denials you see coming back to your practice.

Within the past couple of months, stay-at-home restrictions and social distancing due to the Covid-19 pandemic have resulted in a dramatic increase in the use of telehealth. In the past, telehealth was nice to have around and came with some significant restrictions, but the pandemic has propelled it forward. However, without telehealth reimbursement parity, the advancements made within the past months could be lost. This is why many providers are already letting policymakers know that the current changes in payment policies need to stay in place, even once the pandemic and corresponding public health emergency is over (or at least under control).