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The Ultimate Guide to    Denials Management

Why does a claim get denied by insurance in the first place?

There are countless reasons that a claim may be denied by an insurance company. With such an extensive list of denial reasons, it can get hard to keep track.

Ensuring that you are submitting clean claims can help to reduce the amount of denials that your organization sees up front. Click here to learn more about denied claims and download our infographic full of helpful industry statistics. 

DOWNLOAD INFOGRAPHIC

 

 

 

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Top 5 medical billing denials 

  • Timely Filing
  • Medical Necessity
  • Behavioral Health
  • Incarcerations
  • Coding Errors

 

So, what are the different types of denials? 

There are various types of denials but one of the most common is Medical Necessity. 

Essentially, a Medical Necessity refers to a treatment that a patient received that does not meet a certain level of severity to be considered medically important enough to warrant that treatment. 

Different types of healthcare insurance denials

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Insurance denials aren't going anywhere.
In fact - they're increasing.

The global healthcare claims management market is expected to reach nearly $14 billion by 2023. 

This growth is due to several different factors.

Including:

  • Growing patient volumes
  • Expanding health insurance market
  • Declining reimbursement rates

learn more about the growing insurance denials problem