FAQS
- Just one unresolved denial a week can result in over $5,000 in lost revenue
- 90% of claim denials are preventable
- The Advisory Board reported in 2014 that 90% of claim denials are avoidable and the most common claim denial reasons demonstrate that. According to the 2013 MGMA health insurer report card, most claims were denied for the following reasons:
- Missing information, such as absent or incorrect patient demographic data and technical errors
- Duplicate claim submission
- Service already adjudicated
- Services not covered by payer
- Time limit for claim submission already passed
- Physician Groups, Hospitals, Pharmacy, Long term and Short term Patient Care Facility, Ambulatory Surgery Centers, Urgent Care Centers
- Private Practices, Hospital Employed Groups, Specialties
- Medical Center, Multi-Hospital System, IDN
- Outpatient Center
- Physician Practice/Physician Group
- Skilled Nursing Facility