Main Points to Cover:
- Current Statistics:
- Up to 26% of claims contain errors, leading RCM to significant overcharges or underpayments.
- 12% of all healthcare claims are denied, with 85% of these denials being avoidable.
- Major Causes of Errors:
- Coding inaccuracies (e.g., incorrect ICD-10 entries).
- Missing or outdated patient information.
- Lack of prior authorization for services.
- Impact on Revenue:
- A Pennsylvania clinic reduced denial rates by 23% through proper eligibility verification, improving collections by 25%.
- Practices utilizing updated software have seen denial rates drop to as low as 2%, increasing revenue by 10% within months.
- Proactive Solutions:
- Invest in automated billing software to streamline claims processes.
- Conduct regular audits to identify and correct billing inefficiencies.
- Partner with specialized revenue cycle management (RCM) services for expert guidance.
Conclusion:
Reducing billing errors isn’t just about improving revenue; it’s about ensuring better patient care and operational efficiency. With advanced tools and strategic RCM partnerships, healthcare providers can safeguard their financial stability and focus on what matters most—delivering quality care.
