Industry studies consistently find that most claim denials are preventable, and a large share of denied claims are never resubmitted. Every one of those is revenue your practice earned and never collected.
Start at the front desk
Registration and eligibility errors are still the leading cause of denials. Verify coverage 48 to 72 hours before every visit, capture insurance card images, and confirm coordination of benefits for patients with more than one plan.
- Run real-time eligibility on every scheduled patient
- Flag services that need prior authorization
- Confirm demographics exactly as they appear on the insurance card
Scrub every claim before it leaves
A payer-specific claim scrubber catches NCCI edits, modifier conflicts, and missing data. Pair automated scrubbing with human review of high-dollar claims.
Turn denials into data
Categorize every denial by CARC/RARC code, payer, provider, and root cause. Review the trends every month and assign an owner to every fix. Denial management works when it prevents the next denial, not only when it recovers this one.
