Practice managers and medical billing specialists are knowledgeable, trained professionals who submit and process medical claims on behalf of healthcare providers and their patients to insurance companies. These invaluable team members must stay current on medical billing codes, be aware of patients’ plans and benefits, and manage the practice’s revenue cycle.
Even in the hands of an educated and capable medical billing specialist, insurance claims can still be denied. Denied claims are inevitable, but too many of them can pose a big problem for your practice and your patients.
Your medical claims denial rate is a key metric for evaluating your practice’s performance and financial health. As such, clinicians and their staff should pay special attention to trends, changes, and problems in their billing and revenue cycle management processes. By calculating, tracking, and working to improve your practice’s denial rate, you can increase cash flow and protect your reputation and your patients’ peace of mind.