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Claim denial management for Las Vegas practices

A denied claim is money you already earned. RemitReady Medical Billing tracks every denied or underpaid claim for practices in Las Vegas, Henderson, North Las Vegas and across Southern Nevada, and works it until it is paid or truly closed.

How we handle a denial

1. Log it. Every denied or underpaid line from the remittance goes on one follow-up list with the client, date of service, payer and amount.
2. Explain it in plain words. We translate the payer's reason code into what actually went wrong and what fixes it.
3. Track the deadline. Each payer and plan sets its own timely filing and appeal windows. Every denial is logged against its due date so nothing slips past.
4. Fix it. We correct and resubmit the claim, or prepare an appeal with the records it needs.
5. Report what was recovered. You see what was denied, what was fixed, what was paid, and what is still open.

Common reasons claims are denied

• Coverage ended, or the client was billed to the wrong plan
• Missing or expired prior authorization
• Duplicate claim submissions
• Coding or modifier problems, including telehealth
• Provider enrollment or credentialing issues with the payer
• Claims sent after the payer's filing deadline

Many of these are preventable. That is why we also check eligibility before the visit and review each claim before it goes out.

Payers we work with

We follow up claims for Nevada Medicaid, Medicaid managed care plans and commercial insurance, based on the payers your practice already bills. We work with behavioral and mental health practices, psychologists, counselors and community health worker programs, from solo providers to small groups.

Have denials piling up? Request a free billing review or call (702) 466-4159.