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8 Tips for Reducing Insurance Claim Denials

For those who work in the behavioral health field, navigating the complexities of billing procedures can provide its share of headaches. A busy practice can spur missed essentials in coding. Steps and policy updates can be inadvertently skipped. However, to maximize profits and minimize downtime for revisions, it’s crucial that your staff place a major focus on reducing billing mistakes.

Here are eight ways you can approach billing that can reduce the chance of those claims taking more of your time than absolutely necessary:

  1. Avoid Clerical Errors. Take your time to confirm patient and provider information is correct up front. Verify all names, addresses, contact and insurance information, date of birth, etc. for every single patient and insurance provider are up to date with each claim submission.
  2. Verify Requirements for Referrals or Prior Authorization. While some insurance companies allow a certain number of visits without a referral, this is by no means standard across the industry. Also, it’s crucial to obtain preauthorization if required. Don’t assume with any given patient that “this visit is covered” — take the time to ensure all requirements are met for the visit before a patient’s appointment. Using a mental health software program that includes integrated eligibility verification can streamline this process.
  3. Ensure Coding Is Relevant. With coding changes happening frequently, it’s imperative to familiarize yourself with the latest ones when they’re released. It’s easy to rely on standard procedure codes, only to discover the patient’s insurance has rejected the claim. Do you know the most recently released codes? Using mental health software which features automatic coding can improve coding accuracy and ensure that the mental health note supports the billing code on the claim.
  4. Check for Missing Information. Any claim with missing information on the patient, provider, insurance or procedure will obviously be denied. No matter how busy your practice is, any time gained by glossing over any of this information be lost when it is sent back by the insurer. Due diligence is vital here, and taking the time to make sure no stone is left unturned will save your team from headaches down the road.
  5. File Claims Promptly. What’s a simple method to throw money away? Miss your timely filing deadline. The hard work of your doctors and staff is far too valuable to risk it going unpaid, so be aware of the filing deadlines for each insurer. Since these can vary from as long as a year to as short as 90 days, pay close attention to which insurer is being billed for every single patient. Your bottom line will thank you.
  6. Confirm Coverage for Specific Plans. With a dizzying variety of health plans currently on the market, no provider can assume any given one offers coverage for a specific treatment. Prior to a patient’s visit, confirming with their insurance that certain treatments are covered under their plan will play a huge role in reducing denied claims.
  7. Verify the Correct Insurer. While some insurers accept all billing directly, many others have partners or subsidiaries that handle specific types of claims, such as those related to mental health. If you aren’t familiar with the structure of a particular insurer, call to verify they accept your billing directly prior to a patient’s appointment. If they don’t, make absolutely sure you have all information for their specific billing channels in your system.
  8. Follow up on Claims. Communicate with your patients’ insurers frequently when possible. While any high-volume environment will increase opportunities for mistakes to occur, you can reduce denied or rejected claims by working with insurers to catch problems before the denial. This can save you time in the long run and speed up the time it takes to be paid.

ICANotes Can Help Improve Your Efficiency and Accuracy

The easiest method for helping reduce denied and rejected claims is to implement the ICANotes Mental Health EHR in your clinic. We offer a free trial your team can easily evaluate and appreciate. Visit our Features page to learn how ICANotes offers improved efficiency through charting, billing, scheduling and practice management. We are also available via phone if you have any questions — give us a call at 866-847-3590.

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