Top 5 Denial Reasons & How to Prevent Them

Did you know that over 30% of healthcare claims are initially denied or rejected? While not all denials can be prevented, most are avoidable with the right processes in place.

Top 5 Denial Reasons:

1. Eligibility Issues: Patient not covered on the date of service.
2. Incorrect Coding: Wrong or outdated codes lead to instant denials.
3. Missing Information: Lack of supporting documentation or signatures.
4. Duplicate Claims: Submitting the same service more than once.
5. Untimely Filing: Claims submitted after payer deadlines.

Prevention Tips:

• Always verify insurance before appointments.
• Keep coding updated and accurate.
• Use checklists before claim submission.
• Track rejections and learn from them.
• Automate your denial management.

Conclusion:
With Revenue Control (Ctrl), our denial management team ensures fewer denials and faster reimbursements through data-driven improvements and proactive follow-ups.