CLAIM DENIED—an all-too-familiar message. Was your claim filed too late? Was the modifier not recognized? Was the performed service not covered? Was the patient ineligible on the date of service? Was the claim form not filled out properly? Or were you told you were not authorized to perform a particular service (eg, nebulizer treatment for anasthmatic)? Denials are not just annoying—it is important to know why claims are being denied, what you can do to get reimbursed for those services, and how you can prevent it from happening again.

Some problems are easy to correct. With electronic filing, there is proof of the date that the claim was filed. You can also verify that all of the information was submitted correctly. Many other issues, however, will take considerable time, effort, and persistence to remedy. Some individual practitioners feel unable to devote the necessary time or believe that special expertise...

You do not currently have access to this content.