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392: Insurance Denials and Rejections: Why Do They Happen, and How Do You Fix Them?
Are you a clinician in private practice who has considered taking insurance–but you just aren’t sure? Maybe you already take insurance, but are overwhelmed with navigating denials and rejections. Either way, today’s session is packed with helpful information and strategic tips. Join us to learn more!
Our Featured Guest
Jeremy Zug
Jeremy Zug is a partner at Practice Solutions, which offers support and insurance billing for therapists and private practices. Their mission is to partner with and empower providers to focus on patient care by removing the burden of billing. Jeremy shares information about denials and rejections, the difference between the two, and how to fix them. He also shares the top three reasons for denials and rejections. We are thrilled to welcome Jeremy as a returning guest to STC!
You’ll Learn:
- What is a denial?
- The tricky layers of denials
- What is a rejection? (This is better than a denial and is usually fixable in a short amount of time.)
- Assessing your risk tolerance (low, medium, or high?)
- Fact: Some insurance companies are easier to work with than others. (Check their denial rates!)
- Insurance companies’ tactics to “control the spend”
- Jeremy’s advice about denials and appeals, especially for solo practitioners
- The top three reasons for denials: duplicate claim and service, coordination of benefits, and “denied for medical necessity”
- The top three reasons for rejections: credentialing issues, patient demographics, and “modifier inconsistent with place of service”
- The top actions therapists can take to fix denials and rejections: track them, look for a pattern/cause, and manage your insurance mixture
- An overview of Practice Solutions and their services (book, billing, and billing department support) Use this link for 20% off any of their services for STC listeners!
Resources:
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