Denial Management in medical billing  Causes of Claim Denials.ppt
                     
Denial Management :
Causes of Claim Denials
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Incorrect Coding: 
Use of an incorrect CPT code is a key 
reason for claim rejection. The recent 
change from ICD-9 to ICD-10 also 
complicates the coding process , adding to 
these challenges.
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Incorrect Patient Information:
 Incorrect DOB, wrong insurance ID, and/or 
missing information are some other common 
errors that lead to claim denial.
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Eligibility Verification: 
The patient is not eligible for a specific 
treatment or has no insurance 
coverage.
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Duplicate claim submission: 
Submitting the same claim twice can result 
in rejection of both.
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Wrong POS: 
Hospital, emergency room, office, or 
nursing home have a different 2 digit code 
that must match the CPT code used.
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