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Medical Claim Denials Blog Posts

Decoding Common Denial Codes: Duplicate Claim or Service

Harold Gibson

Every medical practice deal with claims denials, which is a notice that the claim has not been paid for specific reason. While there are many different denial codes you may see from time to time, one of the most common denial codes is the denial for a duplicate claim or service. Unfortunately, duplicate claims are both counter-productive and costly for your practice, not to mention, they can end up getting you into trouble. Too many errors can result in the imposition of program integrity actions by the Medicare administrative contractor against your practice. This means it’s essential to learn more about this common denial code, how to avoid it, and what you can do when it does happen.  

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Topics: medical claim denials, claim denials, duplicate claim denial

Decoding Five Common Denial Codes in a Medical Practice

Harold Gibson

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.

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Topics: medical claim denials, claim denials

Decoding Common Denial Codes and Missing Modifiers

Harold Gibson

One of the common reasons your medical claims may be denied is for missing modifiers or invalid modifier combinations, which basically means that your procedure code isn’t consistent with the modifier you’ve used. Accurate coding of treatment is essential, but it’s also important to ensure you include modifiers when necessary and ensure you’ve used the correct one for the code you’re using.

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Topics: Medical Coding, medical claim denials, Missing Modifiers

5 Ways to Prevent Claims From Being Denied and Improve Collections

Patrick Dougherty

Getting claims paid in a timely manner and as efficiently as possible is vital to the strength and longevity of your medical practice. According to some estimates, it costs medical providers an average of $6.50 to file each claim with an average of 5 to 10 percent of these being denied. When claims are re-submitted, the cost to do so jumps as high as $118. Up to 65 percent of denied claims are never even re-submitted at all. 

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Topics: medical claim denials, claim denials

6 Most Common Factors to Avoid Medical Claim Denials and Increase Revenue

Patrick Dougherty

It will probably come as no surprise, that medical claim denials are on the rise, for both physicians and hospitals. With this rise come serious and expensive challenges for healthcare organizations and providers alike, with lost revenue projected to run into the billions of dollars. Considering that many otherwise re-billable claims are allowed to languish unbilled and unpaid, denials need to be avoided at the onset and if they occur, dealt with immediately.

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Topics: medical claim denials

About this blog

A place for physicians and other healthcare stakeholders to share and discover information about everything related to running efficient medical practices.

Established in 2002 by a group of physicians, we are a national provider of medical billing services to group practices, clinics, and individual physicians. We also specialize in provider credentialing, payer contract reviews, and medical coding for a wide range of clients - from solo practitioners to multi-site, multi-specialty practices.

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