Did you know that scheduling and registration errors account for nearly 50% of denied claims? The promising yet also frustrating news is almost 100% of these denials are preventative. In today’s post, we’re going to discuss common reasons why this happens and how you can address the root cause. We’ll also guide you on exactly what information your front desk team needs to be collecting for every visit, regardless of whether it’s a new patient or an existing patient.

The first question you’re probably asking is, why is your front desk team missing these errors? Your initial response may be to reprimand the team for making mistakes. The reality is that we’re all human and make mistakes. However, it’s not as simple as telling your front desk staff to do better and stop making mistakes. Aside from human error, there are several other reasons why front desk denials occur.

Reducing denials is all about being able to identify the trends. How often is someone from your practice reviewing the denial codes and reasons to determine your top denial reasons? If your practice is not doing it currently, the time to start is now or if you’re doing it infrequently, start making it a monthly exercise. The answer to why front-end denials are happening lies in the data. Once you’ve identified the trends, it’s time to figure out the why. Here are three common factors that could answer why your practice is seeing such a high percentage of front-end denials.

Training

Are you confident in your staff’s training? Front desk teams that are improperly trained will, without a doubt, make mistakes. Front desk staff needs to be trained not only on patient interaction and managing the schedule, but they also need an in-depth understanding of insurance and the claims process if they’re expected to collect patient information. Training is also not a one-and-done exercise. If there’s one thing you can count on in healthcare, it’s change, and your practice needs to ensure training on changes is happening. Regular training sessions are imperative to reducing front-end denials. Even if nothing’s changed, reviewing what’s required during scheduling and registration will go a long way.

Lack of Bandwidth

Are the mistakes being caused by the fact that your front desk and scheduling staff are too busy to make sure they’re collecting and verifying patient information? Given your patient volume, is it unrealistic to expect them to collect and verify every patient’s information in addition to their other responsibilities? Keep in mind your front desk staff is also the face of your practice. If patients observe staff running all over the place and so busy they’re unapproachable; your patient satisfaction rate will suffer.

Process

Are you using technology and operational processes that give your front desk staff the best chance to succeed? EMR and practice management software should support the scheduling and registration process. If your team finds it difficult to navigate or time-consuming, it’s time to look at what changes can be made to the current system or evaluate another system that would better support your practice. It’s also good to assess your internal billing operations process from beginning to end to ensure you’ve got the right people in the right position and processes that drive efficiency.

As you’re identifying the cause, here’s a reminder on what patient information must be collected at every patient visit.

• Verify patient demographics
  • Name
  • Birth Date
  • Address
  • Phone Number
  • Any changes since their last visit

• Patient insurance information
  • Any changes in insurance coverage
  • Collect or confirm insurance provider
  • Ask about secondary insurance
  • Collect or confirm the patient’s identification number
  • Collect or confirm the patient’s group id

• Insurance verification
  • Make a copy of the patient’s insurance card
  • Call or visit the payor’s website to confirm the patient’s coverage
  • Confirm patient’s insurance plan details
    • Amount the patient’s deductible
    • Required pre-authorizations
    • Included coverage
    • EDI payor ID
    • Referral requirements
    • Medical necessity LCM and NCD requirements

We understand how frustrating denials can be for practices and the impact they have on your revenue. Hopefully, we’re encouraged you to the first step into addressing your front-end denials by finding the root cause. If you’re still frustrated and are ready to call in an expert, OmniMD is here to help! Click here to schedule a call.