What's on it
Most denials come from a handful of fixable causes. Catch them at the front end and your team spends far less time on appeals.
Before the claim
- Eligibility checked for the date of service
- Correct primary and secondary insurance recorded
- Provider enrolled with the payer on the date of service
- Authorization or referral number on file where needed
On the claim
- Anesthesia code matches the procedure performed
- Diagnosis supports the procedure and any MAC
- Staffing modifier matches the record
- Time reported the way the payer requires
- Separately billed blocks and lines carry the right modifiers
After the claim
- Rejections fixed and resent within days
- Denials sorted by reason every month
- Top two causes fixed at the source
- Nothing allowed near its timely filing limit