Demographic entry and Charge transmission

As reported by The Change Healthcare 2020 Denials Index which is an analysis of 102 million hospital transactions valued at $407 billion in total charges across more than 1,500 U.S. hospitals, the average medical claims denials rate is up 23% since 2016, topping 11.1% of claims denied upon initial submission through the third quarter of 2020. Since the onset of COVID-19, denials have risen 11% across America. It was found that 86% of claim denials were potentially avoidable and around 75% were still recoverable. Missing or Invalid Claim Data was a significant cause of claim denial that accounted for 17.2% of all denials. The inference here is that a lot of revenue loss is occurring for healthcare professionals that is preventable.  Patient demographics and charge entry which is often overlooked as a miniscule task, if not correct, may lead to claim denials and have major implications in your revenue cycle.

Clean claims without errors and with accurate coding are the only ones which get transmitted through EDI (Electronic Data Interchange) to the insurance company.