Insurance Claim Denial -Codes and Reasons

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An insurance claim denial can be a headache for healthcare providers, and navigating this side of medical billing can be a real challenge.

Encountering insurance claim denials or rejections from Managed Long-Term Care (MLTC) or insurance companies can disrupt the payment cycle and even strain patient-provider relationships. That's why understanding the root causes of these denials is crucial.

In this video, I delve into the most common reasons for these denials, like incomplete or inaccurate information, billing errors, authorization issues, and coverage limitations.

Understanding the provider guidelines and adhering to them is crucial to avoid common billing errors. Double-checking all information before submission ensures accuracy. Obtaining prior authorizations, when required, prevents denial issues. And importantly, following up on denied claims with the payer can resolve issues efficiently.

These steps are crucial in ensuring claims get paid promptly and avoiding insurance claim denials.

Learn the crucials Do's and Don'ts. Save time, money, headaches and discover practical tips to ensure smooth claims processing and maximize reimbursement.

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00:00:00 - Introduction to our Healthcare Channel
00:00:31 - Common Reasons for Claims Denials in Healthcare
00:01:09 - Common Reasons for Claim Denials
00:02:17 - Factors affecting claim payment
00:02:51 - Common Denial Reasons in EOB
00:03:27 - Understanding Denials and Rejections from the MLTC
00:04:01 - Tips for Submitting a Claim
00:04:36 - Avoiding Denials and Rejections from Insurance Companies
00:05:12 - Need Help with Denials or Rejections?

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