There are two main ways that insurance companies respond when they decide not to pay a claim, denial and rejection. Both indicate the claim will not be paid, but there are some important differences between the two. The distinction is critical for medical providers to correctly follow-up so they can get claims paid appropriately. Let’s […]
Claim Denial, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clearinghouse Rejection, Denial vs Rejection, Denied Claims, Healthcare, Healthcare Billing, Medical, Medical Billing, Payer Rejection, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization
When a payer denies a claim, they do not simply say no. They send back a code. That code is supposed to tell you why the claim was rejected and what, if anything, you can do about it. In practice, denial codes can be cryptic, inconsistent across payers, and easy to misread if your billing […]
Denial Codes, Denial Management, Denied Medical Claims, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Outsourced Billing, Revenue Cycle Management, Revenue Cycle Optimization