A common error that can cause a claim to be rejected is missing or incorrect patient information on the claim form.
Things such as incorrect addresses, inaccurate insurance details or even misspelled names can easily cause a claim to be denied and rejected due to any mismatches with the records of the insurance company.
Other reasons for claims to be rejected or denied are incorrect billing codes and using the wrong medical codes for procedures or medical diagnoses.
Missing required information such as leaving out the necessary details on the claim form.
Duplicate billing such as submitting claims to the company for the same service multiple times.
Lack of medical necessity such as when the insurance company determines that a procedure is not or was not medically necessary.
And failure to obtain prior authorization by not getting required pre approval for certain services.
Whether it was by accident or was done intentionally, medical billing and coding errors are common reasons that claims are rejected or denied.
Information may be incorrect, incomplete or missing.
The most common reasons for claims to be rejected include.
Incorrect or missing information on the claim form.
Probably the most common reason that a claim is rejected is simple mistakes on the claim form.
Errors in billing and coding.
Prior authorization and referral issues.
Duplicate billing.
Timeliness of filing the claim.