Day 5: Denial Management and Resubmission

Day 5:

Denial Management and Resubmissio

Session 1: Denial Reasons and Solutions

Common Denial Reasons:

·        Incorrect patient or insurance information.

·        Missing codes or documentation.

·        Services not covered by insurance.

Steps to Resolve Denials:

·        Analyze the EOB or denial notice.

·        Identify the reason for denial.

·        Correct errors and resubmit the claim.

 

Session 2: Resubmitting Corrected Claims

Best Practices for Resubmission:

·        Ensure corrections address all denial reasons.

·        Attach supporting documentation if needed.

·        Track resubmitted claims for follow-up.

Hands-on Activity:

·        Correct and resubmit sample denied claims.

Session 3: Effective Communication

Tips for Interacting with Payers and Patients:

·        Be professional and courteous.

·        Maintain clear and concise communication.

·        Document all interactions for reference.