Denial Codes

Still thinking about your denied claim? Look at the denial code to discover the reason. Each code highlights different issues in your claims, from coverage limitations to incorrect or missing payer information. By understanding the most recurring reasons, you can avoid the patterns or mistakes in your billing process that result in claim rejections. So, […]

According to the U.S. Centers for Medicare & Medicaid Services, private and government health insurance payers process over 5 billion medical claims annually. A complaint submitted to the U.S. Department of Justice stated that nearly 95% of these medical claims are transferred electronically via EDI clearinghouses.  Since the rise of electronic medical claim filing, clearinghouses

Getting your claim denied due to billing errors like incorrect coding and missing or inaccurate information is one thing. But have you ever submitted a claim to the wrong payer? If you have, then you might already be familiar with the CO 109 denial code. Claim denials are a common problem for many healthcare providers,

Insurance policies are already quite complex. To make matters worse, around 43 million people (mostly senior citizens) have more than one insurance plan, according to the United States Census Bureau. Due to this, many healthcare professionals fail to identify their patients’ primary and secondary insurance coverages. As a result, they submit claims to the wrong

Understanding the alphanumeric denial codes is your key to contesting the rejected reimbursement.  In today’s guide, we will decode the CO 167 denial code and help you comprehend why a payer triggers it, what can be done to prevent it, and how you can reverse it.  So, brace yourself as we navigate the maze of

As a healthcare provider, you spend most of your time seeing and tending to patients.  Charting patient symptoms, drawing diagnoses, and deciding on the best treatment plans while keeping the patient engaged are necessary to keep your MIPS score high.  Already, keeping the billing and payment cycle optimized for faster reimbursements is a constant struggle.

Claim denials and reimbursement delays can keep any healthcare provider up at night. It is not a secret that these problems compromise the quality of the services and hinder the financial growth of a practice. Among various billing errors, duplicate claims are the most frequent problem. Insurance companies use the CO 18 denial code to

There is a time limit for everything, including filing a medical claim. Insurance providers offer varying time limits for submitting medical claims. While some payers have a 90-day limit, others give you a year to file for reimbursements.  However, one thing remains constant. Insurance companies set their deadlines based on the date the service was

No matter how much of a medical billing expert you might be, you will have claims denied. Denied claims are a hassle, causing delays, an extra dent in resources, and unnecessary financial setbacks.  Every year, $262 billion are denied in medical claims, and sadly, 90% of these denials are preventable. The key is to understand

Seeing hundreds of patients, managing documentation, processing claims, and following up on payments is not easy when you try to juggle everything in-house, especially if you are a solo practitioner. In such a hectic routine, making mistakes becomes normal. However, getting denials or every claim can exhaust you financially and make it challenging to keep