{"id":193,"date":"2020-05-15T18:38:49","date_gmt":"2020-05-15T18:38:49","guid":{"rendered":"https:\/\/www.bradybilling.com\/blog\/?p=193"},"modified":"2020-06-15T18:39:58","modified_gmt":"2020-06-15T18:39:58","slug":"why-do-insurance-claims-get-denied","status":"publish","type":"post","link":"https:\/\/www.bradybilling.com\/blog\/why-do-insurance-claims-get-denied\/","title":{"rendered":"Why Do Insurance Claims Get Denied?"},"content":{"rendered":"\n<div class=\"wp-block-image\"><figure class=\"alignleft is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.bradybilling.com\/blog\/wp-content\/uploads\/2020\/06\/AdobeStock_209967239__1592187406_52746.jpg\" alt=\"Animated image of a \u201cDenied\u201d stamp sitting on an insurance claim \" class=\"wp-image-194\" width=\"319\" height=\"228\" srcset=\"https:\/\/www.bradybilling.com\/blog\/wp-content\/uploads\/2020\/06\/AdobeStock_209967239__1592187406_52746.jpg 800w, https:\/\/www.bradybilling.com\/blog\/wp-content\/uploads\/2020\/06\/AdobeStock_209967239__1592187406_52746-768x552.jpg 768w\" sizes=\"auto, (max-width: 319px) 100vw, 319px\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Wondering why your patient\u2019s medical insurance company\ndenied their claim? Trying to figure out what you should do to help them get\nthe treatment they need to improve their health and sleep patterns? Before you\nwatch your client walk away in search of another dentist who can provide care,\nlet a third-party <a href=\"https:\/\/www.bradybilling.com\/denials-and-appeals.html\">medical billing<\/a>\ncompany explain the process and what they can do to help both you and your\npatient. <\/p>\n\n\n\n<!--more-->\n\n\n\n<h2 class=\"wp-block-heading\">Why Does a Claim Get Denied?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">If it could only be crystal clear why a claim is denied, it\nmight make your job and those of your staff members much easier. Unfortunately,\nthat is simply not the case. When filing a claim with medical billing for sleep\napnea, certain steps must be followed in order for it to be approved. This\nprocess is often why most dental offices opt to allow a third-party company to take\ncare of this instead of putting the burden on in-house administrative staff. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">To better understand why a claim was denied, here are a few\ncommon reasons:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Medical insurance deems the treatment\nunnecessary or non-essential. <\/li><li>No prior authorization was received.<\/li><li>Your patient\u2019s sleep apnea is not considered\nsevere enough, or they are receiving effective treatment with a CPAP machine. <\/li><li>There were coding errors or omissions during the\nclaims filing process.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">It is important that your team or outside agency read the\nterms of the patient\u2019s medical insurance provider to determine how severe the\nsleep apnea diagnosis must be in order to be approved for an oral appliance.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How Brady Billing Can Turn a Denial into an Approval<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">While it is easy to assume that your in-house staff can\nhandle all the intricacies associated with the medical insurance filing\nprocess, it often a welcome change when dental professionals like yourself\nchoose to employ a third-party medical billing company like Brady Billing. Equipped\nwith a team of individuals who are experts when it comes to working with insurance\ncompanies, they can easily navigate the processes and steps required to help\nyou and your patients have a successful experience. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">So, how can they remedy a denied claim? <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If the claim is denied, Brady Billing can opt to file an appeal\nthat will counter the medical company\u2019s reasons for denying it in the first\nplace. Their professionals will continue to seek compensation and submit\nadditional documentation before requesting that the insurance company reconsider\nits decision.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">But before it is ever formally filed, there is a unique\nsystem that Brady Billing follows to ensure the number of rejections or denials\nis significantly less. Opting to push the claim through a process known as a\npreliminary clearing, this allows for any coding errors or omissions to be picked\nup before it is officially filed. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">While it is your responsibility to provide in-depth,\nthorough evidence of your patient\u2019s need for oral appliance therapy, Brady\nBilling can make sure all necessary information is collected, addressing any potential\ndiscrepancy before it is submitted for claims approval. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>About Brady Billing<br>\n<\/strong>We specialize in dental offices that provide sleep medicine services and\noffer billing services for dentist offices throughout the country. By offering\na range of billing services, we can assist in answering your questions and\nproviding a complimentary consultation to discuss available services. To find\nout how we can help you, visit our <a href=\"https:\/\/www.bradybilling.com\/contact-us.html\">website<\/a> or call <strong>(844) 424-5548<\/strong>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Wondering why your patient\u2019s medical insurance company denied their claim? Trying to figure out what you should do to help them get the treatment they need to improve their health and sleep patterns? Before you watch your client walk away in search of another dentist who can provide care, let a third-party medical billing company [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-193","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Medical Billing | Sleep Apnea Claim Denial | Brady Billing<\/title>\n<meta name=\"description\" content=\"Wondering why your insurance claim was denied? 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