Denial Codes

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

Denials and payment delays can negatively impact your healthcare organization’s revenue cycle. Therefore, avoiding denials should be a priority and you must strive to improve your first-pass claim rate because appealing and reworking denied claims require both – time and money.  This guide will help you understand denial code CO 11, issues that trigger it,

Did you just get hit with another denial? If it is the denial code CO 4, then breathe a sigh of relief because your revenue is not lost, just a little delayed. The CO 4 denial is triggered when the procedural code is inconsistent with the modifier used. Although the CO 4 denial code can

How can we address the most common denials in medical billing without understanding them? The ideal scenario for any healthcare provider is to receive payments on time. But it has become increasingly impossible with the rise of claim denials. According to an analytical report, the claim denial rate on inpatient treatments and procedures increased by

Contractual obligations, service coverage, and coding! Medical billing is a complicated process for an average healthcare professional. Insurance policies vary from provider to provider, covering different services at varying contractual rates. A single mistake can lead to your insurance company denying or rejecting your medical claim. But how can you identify the reason for your

Don’t let the complexities of medical billing affect the quality of your services. Healthcare is a demanding industry. As a healthcare provider, you don’t want the additional stress of claim denials while dealing with long working hours and burnout.  However, getting the insurance companies to reimburse your medical claims on the first try is quite

Is denial code 23 affecting your healthcare practice’s revenue cycle? Don’t fret! We understand your concerns.  We have come up with this comprehensive guide to discuss the reasons that trigger this denial code and share some best practices to help you avoid it. In case your claims get tagged with denial code 23, our resolution

Denial code 253, also referred to as CO 253, is a mandatory payment reduction enforced by the federal government on reimbursements for healthcare services or procedures.  If you are a Medicare-approved provider, then this sequestration will be applied to all your claims. Hence, it is important to understand the common reasons behind these sequestration-related denials,