3 Scary Electronic Claims Habits that Hurt Your Acceptance Rate

As Halloween approaches, VisionWeb couldn’t think of anything more frightening than a payer slashing through your revenue by denying your electronic claims and delaying your income. We’ve put together a few solutions to the most common claims management fears to shine a light on your claim nightmares.

Below are three haunting reasons insurance companies might deny your claims.

The Most Haunting Reasons Your Electronic Claims were Denied

Your Biller Submitted a Duplicate Claim

The most common reason for a payer to deny your electronic claim is that your biller submitted multiple claims with repeated information. This typically happens when the billing manager finds an unpaid claim and resubmits it without identifying the original claim submission. To avoid this reason for a denied claim, use the resubmission feature within your electronic clearinghouse solution instead of submitting an entirely new claim.

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Your Patient’s Insurance Wasn’t Really There

 Typically, when a claim is denied due to a patient being identified as uninsured, it’s due to a data entry error. To solve this mystery, you can pull the patient’s benefits prior to the exam and double check the information.

You Filed Your Claim Too Late 

 Missing your window to file a claim is the most horrifying reason that a payer denied your electronic claim. While there are a number of reasons why your billing manager missed the claims submittal deadline, it usually comes down to the fact that there were just too many claims that needed to be worked. Help your optometric biller out by prioritizing what claims need to be worked based on the timely filing guidelines.

If you're letting VisionWeb's expert team handle your billing, you don't have to worry about denials. Read a success story below.


Editor's Note: This blog was originally published in October 2016 and updated in 2022.

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