5 Ways P3 Care Can Help You Reduce Denied Claims

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Introduction

Denied claims are a major problem in the healthcare industry, costing providers billions of dollars each year. In fact, a recent study by the American Medical Association found that the average healthcare provider denies 10% of all claims. This can have a significant impact on a provider’s bottom line, especially for small practices.

There are a number of reasons why claims are denied. Some of the most common reasons include:

• Coding errors
• Missing or incorrect patient information
• Services not covered by the patient’s insurance
• Lack of prior authorization

Fortunately, there are a number of things that providers can do to reduce denied claims. One of the best ways to reduce denied claims is to partner with a claim’s scrubber. A claims scrubber is a software program that can automatically review claims for errors and omissions before they are submitted to the insurance company. This can help to catch mistakes before they become problems.

Another way to reduce denied claims is to educate staff on proper coding and billing procedures. Staff should be up-to-date on the latest coding guidelines and should be familiar with the specific requirements of each insurance company.

Providers should also make sure to verify patient eligibility and benefits before services are rendered. This can be done by calling the patient’s insurance company or by using an online eligibility verification tool.

Finally, providers should always obtain prior authorization for non-emergency services. This is especially important for services that are expensive or that are not routinely covered by insurance.

How P3 Care Can Help You Reduce Denied Claims

P3 Care offers a number of services that can help providers reduce denied claims. These services include:

• Claims scrubbing: P3 Care’s claims scrubbing service can review claims for errors and omissions before they are submitted to the insurance company. This can help to catch mistakes before they become problems and can also help to identify patterns of errors that can be addressed.
• Medical Coding and billing education: P3 Care offers a variety of coding and billing education resources to help staff stay up-to-date on the latest coding guidelines and insurance company requirements.
• Eligibility verification: P3 Care can help providers verify patient eligibility and benefits before services are rendered. This can help to avoid claims denials due to ineligibility or lack of coverage.
• Prior authorization assistance: P3 Care can help providers obtain prior authorization for non-emergency services. This can help to avoid claims denials due to lack of prior authorization.

In addition to these services, P3 Care can also help providers to appeal denied claims. This can be a complex process, but P3 Care has the expertise to help providers navigate the system and get the reimbursement they deserve.

Benefits of Working with P3 Care

There are a number of benefits to working with P3 Care to reduce denied claims. These benefits include:

• Reduced administrative burden: P3 Care’s services can help to reduce the administrative burden on providers by automating many of the tasks associated with claims processing. This can free up staff to focus on patient care.
• Improved cash flow: By reducing denied claims, providers can improve their cash flow and their overall profitability.
• Reduced stress: Denying claims can be a stressful process for both providers and their staff. Working with P3 Care can help to reduce this stress by taking the burden of claims processing off of the provider’s shoulders.

Additional Tips for Reducing Denied Claims

In addition to working with P3 Care, there are a number of other things that providers can do to reduce denied claims. These tips include:

• Use a claims management system: A claims management system can track and monitor claims denials. This can help to identify trends and patterns of denials that can be addressed.
• Identify the root cause of denied claims: Once a claim has been denied, it is important to identify the root cause of the denial. This will help to prevent the same mistake from happening in the future.
• Implement a quality control process: A quality control process can help to ensure that claims are accurate and complete before they are submitted.
• Train staff on how to avoid common coding and billing errors: Staff should be trained on how to avoid common coding and billing errors. This can help to prevent claims denials from happening in the first place.
• Stay up-to-date on the latest coding guidelines and insurance company requirements: Coding guidelines and insurance company requirements are constantly changing. It is important for providers to stay up-to-date on these changes to avoid claims denials.

By following these tips and working with P3 Care,

Healthcare billing providers can significantly reduce the number of denied claims they receive. This can help to improve their cash flow, their overall profitability.