07/15/2024

How Oncology Practices Can Fight Claims Denials and Stop Losing Money

Medical insurance denials are on the rise, notably for increasingly higher-cost services. In fact, one recent analysis found that the average denial was linked to charges of at least $14,000. For many oncology practices, denials of this magnitude can be financially devastating; however, there are ways to avoid them.

“In my experience, as much as 90% of front-end denials can be remedied by identifying and addressing procedural gaps in the day-to-day office workflow,” said Tressa Harley, the founder of MD Office Insights, a payer relations strategy firm. “And about 10% can be attributed to errors on the plan’s side, where the claims processing system doesn’t properly capture relevant information on the claim.”

The good news is that many of these issues can be resolved, either proactively or after the practice receives the denial. Consider the following three tips to help head off or appeal costly denials.

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