How to Handle Denials in Medical Billing

01

Review

When receiving a denial, first understand the reason by reviewing the denial code, then proceed with next steps.

02

Revise

Correct errors and add missing info to clarify the claim for the insurer, then revise and proceed with your appeal.

03

Request Appeal

Two appeal types: Internal (ask insurer to reconsider) and External (third-party reviews insurer's decision).

04

Reach Agreement

After submitting your appeal, the insurer will review it. If denied, revise and try again based on their feedback.

05

Reinstitute Prevention

To reduce denials, review claims for errors, act promptly, and improve processes. Fixing issues boosts revenue and decreases denials.

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