What is healthcare denial management? What to look for in a denial management solution?
Denial management is the processing, analysis, and communication of denied claims. Unlike rejected claims (rejected because of errors or anomalies in the claim forms), denied claims are rejected after claims processing. Claims are denied because of non-covered services, non-separate services, incorrect usage of modifiers, and inconsistent data. For healthcare providers and practitioners, denial of claims is expensive. Although they have a high probability of recurrence, better denial management can minimize their negative effects. How do denied claims impact, healthcare providers? The main impact is on the financials of the healthcare provider. When claims are denied by the payors, insurers, or payers, there is a significant delay in payment. Sometimes, there is no clear timeline of when the payment will be released. Denial of claims could make insurers not release payments at all, especially if it is a non-covered service or treatment. Healthcare providers without custom claims denia...
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