First-Pass Claim Acceptance in MH : Reduce Denials, Boost Revenue

First-Pass Claim Acceptance Mastery: Boost Your Mental Health Billing Success

Mental health practices should monitor Key Performance Indicators (KPIs) that represent multiple elements of the revenue cycle to measure the efficiency of revenue cycle management in medical billing.

One critical KPI is the first-pass claim rate, which shows the percentage of claims approved by insurance companies without asking for additional information or adjustments. A greater first-pass claim rate of 90% or higher indicates proper coding and claim submission.

Why You Should Strive for Excellence in First-Pass Claim Success?

Mental health practices need to proactively identify areas for improvement and make data-driven choices to enhance their revenue cycle management operations by regularly monitoring the first-pass acceptance rate.

Obviously, you would require time, effort, and quality control to increase the number of claims that are paid on the first submission. It is quite possible, however, with certain strategies that reduce avoidable claim denials and make a crucial move toward enhancing revenue cycle management.

Why a Higher First-Pass Acceptance Rate Matters?

First pass acceptance is a more revenue-centric indicator than a clean claim rate since it focuses on real money coming in the door. Improved first pass yield reduces the risk of uncompensated care, which is a further plus for your bottom line.

Higher First-Pass Acceptance Rate means,

Faster revenue cycles

Issues that are treated swiftly reduce slowdowns in accounts receivable.

Lower Operating Costs

Resolving unsolved issues incurs considerable overhead expenses.

Increased Patient Loyalty

Single-step resolution increases patient satisfaction.

Better Reimbursement

Avoiding errors and omissions can avoid claim denials, revenue loss, and finally, better reimbursement.

Tips for Improving First-Pass Claim Acceptance Rates

Want to tune up revenue for your healthcare practice? Collections, rejection management, and resubmitting revised claims are all solid places to start.

First-pass claim acceptance rates are most important in terms of healthcare practice profitability.

Here are some tips for improving first-pass claim acceptance rates

Accurate patient registration and insurance verification

To guarantee correct patient information and coverage, first-pass claim acceptance is critical. Front desk staff should verify insurance coverage and ensure that all required information is submitted correctly during registration.

Accurate coding and documentation

Providers should ensure that they are using the right codes and that they have adequate evidence to support the codes they are using.

Utilizing technology for claims submission

Electronic claims filing can help speed the claims process and decrease mistakes. Healthcare providers should use technology to automate claim processing and ensure that claims are submitted accurately and on time.

Pre-authorization and referral management

Getting pre-authorizations and referrals when necessary can help reduce claim denials. Providers should have clear protocols in place for getting pre-authorizations and referrals, and ensure they are obtained promptly.

Regular staff training and education

Ongoing training and education for staff can ensure they stay current with best practices and standard procedures. This can help reduce errors and improve first-pass claim acceptance rates.

In Conclusion

The greatest benefit of first-pass yield is the revenue cycle insights it can offer. Getting into the routine of submitting claims correctly the first time, maximizes efficiency and revenue. Hence, always strive for the greatest first-pass claim acceptance rates possible.

The increased First Pass Clean Claim Rate of Aegis has transformed revenue cycle management for mental health practices. Their dedication to excellence, superior technology, coding skills, quality assurance methods, and strong payer partnerships all contribute to their outstanding results.

Contact us to improve your mental health practice’s key performance indicators.