Preventing Claim Rejections: 3 Ways to Increase


Preventing Claim Rejections: 3 Ways to Increase Revenue

If the world was perfect, at the finish of every revenue cycle management process (RCM) there would have been a 0% rate of claim denials and 100% rate of payment of the claims. This world is assuredly, imperfect, therefore, all of this is unachievable. There are however, many foolproof ways the RCM processes can be improved for smooth processing by identifying the issues that may present themselves preliminary to them occurring.

Looking at the occurrences of claim denials and rejections by the American Academy of Family Physicians (AAFP) report the average for the claim rejections can be said to be 5-10%. Claim denials and rejections can be proven to be the most complex and complicated of issues that arise in the healthcare system. Usually, claim denial and rejections or delays can be due to short and minor mistakes that are unnoticeable and unavoidable such as minute coding errors and billing errors. However, the main question could be- “How much loss does a healthcare organization face in revenues due to this?”; answer to this question can be provided in the Change Healthcare report that was published in 2017. It said that the true cost is $31.51 for the rejected claims.

There are many significant ways by which healthcare providers can prevent claim rejections, the first being:


Prevention can be ensured by making sure no errors are made in the bills, and by carefully checking the codes for any mistakes. This helps prevent facing any claim rejection or delays as dealing with the problems beforehand rather than solving the problems later ensures reduced cost to collect later on.


Automation as known, claim management is still done manually by the average rate of 35%. Opting for automation would not only save time but also money making sure that the claims at the backend are cleaner and that the administrative costs at the front end are significantly decreased.


Integration is also a way by which we can reduce claim rejections. More synchronized the claims management and more streamlined they are-more is it guaranteed for a simple and an easy way to access the data for real-time analytics. This as a result, presumably prevents medical coding errors.

AltuMED understand and applies all this, our PracticeFit optimizes the whole claim management system with synchronized ease increasing revenues significantly. Contact us for more info.