89% of practices experienced increased claim denials, with 51% saying the increase was “significant.”
(TechTarget)
The anxiety around claim denials takes a heavy toll not only on your well-being but also your financial performance. Population Health reported that providers spend $19.7 billion annually on medical claim reviews. When the review ends in the denial of the insurance claim, further turmoil ensues for the provider.
While knowing how to appeal insurance claim denials is helpful, minimizing them is always the better option to avoid the hassle in the long run.
To help you alleviate the headaches associated with claim denials, here are four trends you should know:
4 Trends For Reducing Claim Denials
1. Optimizing The Insurance Verification Process
The risk of claim denials can start as early as before the patient visits. Without adequate preparation, insurance verification can be arduous and time-consuming at best and fatal at worst.
To ensure that denials are kept at a minimum during the verification process, stringent protocols must be established. Here are some factors to keep in mind:
- Verify coverage before the first visit. Confirm the patient’s plan details and limitations, as well as copays and deductibles. You can also improve patient collection rates by informing patients proactively about their financial responsibility to avoid bad debt.
- Develop a verification checklist. It should help you be more thorough by identifying insurance company terms and limitations to assess and watch out for.
- Update your facilities and materials constantly according to payer guidelines. Inform everyone in your team about the latest policy changes to ensure full compliance and reduce the risk of denials.
2. Utilizing PT Documentation Techniques
Writing SOAP notes is often a time-consuming task that can lead to errors, especially when you’re strapped for time between patients. This can result in invalid claims, either due to the wrong CPT codes being cited or lack of justification.
Thus, improving note-taking efficiency and accuracy simultaneously is crucial to producing accurate documentation while reducing claim denials. Here are some documentation techniques that can help you stay ahead:
- Recording the patient encounter or dictation - Document sessions efficiently by recording the appointment or dictating thereafter, preferably with a compliant audio transcription tool.
- Keeping it concise - Use techniques such as shorthand to speed up note-taking during the appointment
- Using templates - Take advantage of pre-made customizable templates for similar entries
- Documenting in batches - Allot a dedicated timeslot to completing notes in groups to secure momentum and focus for both documentation and patient care
- Being familiar with the EMR - Become more efficient and knowledgeable with your EMR system for smooth usage, especially when inputting data from your draft notes
3. Improving Provider Well-Being
According to a 2022 APTA report, 86.3% of providers agree: administrative burdens like documentation lead to burnout.
While medical documentation is vital to a provider’s workflow, it can significantly weigh down on their well-being over time. This is especially true when considering the ramifications of inaccurate documentation — claim denials being one example.
In this case, it’s crucial to keep your providers’ well-being in mind as they take on the everyday grind of patient care and documentation. Help your team develop their documenting expertise, keep them updated with the latest documentation policy changes, or provide an avenue for them to vent their frustrations.
These things can help them clear their chest, knowing they’ll receive support for their issues.
4. Using A Scribe AI Documentation Tool
Claim denials can occur due to human error. Long, tedious hours of documentation can affect the performance of even the best providers, especially when they want to spend more time engaging with patients.
Fortunately, the advent of AI tools has reached the field of rehab therapy. Scribe AI tools such as ScribePT are designed to eliminate the hassle of documentation, allowing providers to do what they do best while reducing denials.
With so many AI scribe solutions available, finding the right one for your practice can be challenging. To help you chose the best option, here are five features you should look for:
- Intuitive interface - Operates smoothly, is easy to navigate, and has a simple, easy-to-work-with appearance
- Fast and accurate - Generates SOAP notes that transcribe and interpret the recorded appointment precisely
- Adapting to your workflow - Mirrors your documentation style as well as the information structure of your EMR system
- Bang for buck - Charges per month, ideally with no limitations like having a set number of hours
- Works with your EMR - Allows for seamless transfer of draft notes without requiring a lot of clicks on your end
Learn more about how AI can benefit your patient documentation workflow on this blog!
Transform Your Documentation Process With AI
Claim denials can plague your profitability and cause long-term frustration if left unchecked. By implementing these trends into your practice’s workflow, you’ll be able to stay on top of your revenue cycle and rest assured that you’ll be reimbursed properly.
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