Denial Codes

Claim denials are the worst nightmare for every healthcare practice. You must be thinking why. The answer to this is that claim rejections have a significant impact on your practice’s operations. It interferes with everyday work, diverts medical professionals from patient care, and affects the financial flow of your practice.  The first step towards dealing […]

The financial management of healthcare practices is complex. Small mistakes can significantly affect the revenue cycle. However, major disruptions to the healthcare revenue cycle occur because of claim denials.  Denial code 13 is among the most frequently occurring denials and stems from a simple error. It not only affects your revenue but also shows clear

Was your appeal denied with CO 286? You might have just missed the deadline! Yes, even appeals have a time limit, and delayed submissions always result in claim denials. Insurance companies use Claim Adjustment Reason Code (CARC) 286 in such cases.  If you don’t have a habit of keeping up with payer-specific timelines, you might

Claim denials disrupt your practice’s revenue cycle, which you may not immediately notice. Beyond the lost money, each denied claim silently burdens your practice. It diverts valuable staff time from patient care and engagement to endless reworks and follow-ups. Also, it creates a growing pile of paperwork that slows everything down. This constant struggle to

Did you know the place of service (POS) also impacts your reimbursement amount? To standardize healthcare transactions, insurance companies require POS codes with electronic healthcare claims. In fact, it is a law under HIPAA. So, what happens if you use the wrong POS code? You receive a CO 5 denial code! Although this is a

Every denied claim can become a revenue loss if not addressed on time. Insurance companies use standard codes to explain why they reject your reimbursement requests. While some codes are irreversible, the good news is that you can resolve most of them with the right approach and actions. As part of our series on simplifying

Is a high claim denial rate stopping your practice from embracing the financial success it deserves? Are you worried that if you don’t take action soon, you might have to lay off staff or close your practice doors? BUT! Why go to this extreme when you can understand different denial codes, work towards their successful

Did you skip an important billing step—insurance coverage verification? If you did, you might encounter a CO 96 denial code. Claim denials are frustrating and harmful to the practice’s revenue. Denial code 96 is unique because it is not just a billing oversight but a potential patient conflict and a threat to your reputation. It

The core responsibility of healthcare providers involves clinical activities like encountering patients, diagnosing illnesses, preparing treatment plans, and rendering procedures. But, the financial aspects, such as charge entry, code selection, claim submission, payment posting, etc., are also critical for running the practice smoothly. Inaccuracies and inconsistencies in the medical billing process may lead to claim

Claim denials adversely affect a practice’s financial performance, as it means delayed or no payment against the rendered care services. Thus, healthcare facilities strive to keep the denial rate to a minimum either by implementing effective preventive strategies in-house or outsourcing denial management services to a professional revenue cycle management (RCM) company.  Today’s guide is