Denials are one of the biggest drains on practice revenue, yet most are preventable. The key is fixing problems before the claim leaves your office.
1. Verify eligibility every visit
Coverage changes constantly. A quick real-time check prevents the most common front-end denial.
2. Capture complete demographics
Typos in names, dates of birth and policy numbers cause needless rejections.
3. Scrub every claim
Automated scrubbing catches coding conflicts, missing modifiers and invalid diagnosis pairings.
4. Get authorisations first
Know which services need prior auth and document it in the chart.
5. File within timely-filing limits
Track each payer deadline and submit claims within 24-48 hours of the visit.
6. Work denials immediately
Appeal quickly, with the right documentation, while the payer window is open.
7. Track trends
Report on denial reasons monthly and fix root causes, not just individual claims.