5 Common Reasons Medical Claims are Denied – Part 5: Missing Deadlines for Claims Submission


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Every practice manager has a top goal of reducing denied medical claims. In fact, denied claims is one of the main reasons practices today aren’t realizing as much revenue and cash flow as they’ve rightfully earned.

This article is the last in our blog series about common denials and why they are common in healthcare practices. In each article, we’ll dive into the reasons for claim denials and offer solutions for better operations that result in improved financial performance.

Blog Series: 5 Common Reasons Medical Claims are Denied
Part 1: The Pitfalls of Coding Errors
Part 2: Lack of Medical Necessity
Part 3: Missing or Incomplete Documentation
Part 4: Service Not Covered by Insurance
Part 5: Missing Deadlines for Claims Submission

Timeliness is Key: Understanding Claim Submission Deadlines

Timely medical claim submission plays a crucial role in securing reimbursements. Missing deadlines set by insurance companies can lead to automatic denials, causing financial setbacks and administrative headaches.
Insurance companies establish deadlines for submitting claims, typically ranging from 30 to 120 days from the date of service. These deadlines are outlined in the provider manual or plan documents. Meeting these deadlines is necessary for ensuring your claim is processed and considered for reimbursement.

Why Timeliness Matters: The Importance of Submitting Claims Promptly

Timely claim submission is essential for several reasons, many around insurance acceptance and reimbursement. The other major reason is to accelerate cash flow for the practice and get paid sooner for medical services already delivered.

Here are some of the main reasons to submit timely claims:

  • Avoiding Automatic Denials: Many insurance companies automatically deny claims submitted after the designated deadline. This can result in lost revenue and delays in receiving reimbursements.
  • Facilitating Streamlined Processing: Submitting claims promptly allows for smoother processing by the insurance company, minimizing the risk of delays or errors.
  • Improved Cash Flow: Submitting claims sooner means getting paid sooner which improves practice cash flow.
  • Ensuring Data Accuracy: Memories can fade over time. Submitting claims promptly reduces the chance of discrepancies with patient information or service details.
  • Avoiding Financial Penalties: Some insurance companies may impose financial penalties for consistently late claim submissions.
  • Reducing Administrative Burden: Appealing a denied claim adds time and administrative burden to your staff, diverting them from other important tasks.

The Medical Claims Appeals Process: An Uphill Battle

If a claim is denied, you have the right to appeal the decision. However, the appeals process can be lengthy and complex. There are often strict time frames associated with filing an appeal, adding another layer of pressure to navigating the situation.

Beating the Clock: Strategies for Timely Claim Submission

Developing a streamlined billing process is key to ensuring timely submission of claims. Here are some strategies to consider:

  • Invest in Billing Software: Utilizing efficient billing software can automate many aspects of the claims submission process, reducing the risk of missed deadlines.
  • Implement Clear Deadlines Within Your Practice: Set internal deadlines for completing claim forms and submitting them to the billing department, creating a buffer before the insurance company deadline.
  • Regular Audits and Monitoring: Regularly monitor your claims submission process to identify any bottlenecks or areas for improvement.
  • Outsourcing Your Medical Claims Process: Working with an experienced medical billing services company with advanced technology will streamline the RCM process, improve claims accuracy, and speed up financial reimbursements.

Partnering for Timely Claims Submission: How Unislink Can Help

At Unislink, we understand the importance of meeting claim submission deadlines. Our experienced team can efficiently process and submit your claims electronically, ensuring they reach the insurance company promptly. By prioritizing timely claim submission, you will minimize denials, maximize reimbursements, and keep your practice running smoothly.

Our entire team is focused on managing revenue cycle processes for practices, so we fully realize maximum revenue and profits for our clients. Our ultimate mission is to support independent physician practices so they thrive in this complex healthcare landscape.

Gain Control of Your Finances: Discover how KPIs and denial rate tracking improve revenue cycle visibility. Download our free Power of KPIs eBook!

First in this series:
5 Common Reasons Medical Claims are Denied – Part 1: The Pitfalls of Coding Errors