MedClaims International Blog

Clean Claims: The Dirty Little Secret to Efficient Revenue Cycle Management

Posted by Brady Dolan on Feb 13, 2018 11:46:20 AM

Healthcare organizations are continually feeling the pinch when it comes to maintaining company revenue in the current economic environment. With major cutbacks being a last resort option, most are looking for current operating areas where they can save money.

Timely paid A/R is key to effective healthcare revenue cycle management. To be efficient and effective, claims submitted to insurance must be accurate and free of errors, simply known as "clean". Clean claims can be processed quickly, meaning you'll get paid quickly, too.

Find out how clean claims can increase  your revenue [INFOGRAPHIC]

While submitting clean claims might seem like a no-brainer, it's important to note that only 75%-85% of claims that US hospitals submit are actually considered clean. So what about the other 15-25% of claims? Why are they not clean, and where does the issue lie?

There are many reasons why claims are rejected, but some of the most common include:

  • Incomplete documentation
  • Documentation submitted too late
  • Claims for costly treatments or drugs without proper preapproval
  • Missing pre-authorization or pre-certification forms

These errors are common and can be easy to make, so it's important to start the process of crafting a clean claim before the patient even walks in the door. Learn more about what a clean claim looks like, and how to ensure your practice is producing them.  Download our infographic on "The Key to Efficient Healthcare Revenue Cycle Management."

Ultimate Guide to Denials Management

Topics: clean claims, best practices, healthcare revenue cycle