ZOLL Pulse Blog: EMS, Fire & Healthcare Insights | ZOLL Data Systems

How Emergency Medicine Billers Can Break the Claim Denial and Rejection Cycle

Written by ZOLL Data Systems | Dec 17, 2024 5:00:00 PM

In the pressure-cooker environment of emergency medicine, providers are often operating without the staff, time, and information they need. Providing care to patients with high-acuity, urgent cases is rightly prioritized over obtaining demographic and coverage details, but this leads to a quagmire for billers.

Incorrect or incomplete information in the electronic health record (EHR) makes it nearly impossible to submit a clean claim. Denied claims kick start a frustrating and time-consuming cycle of billers hunting down additional patient, payer, and plan information. And if some information, such as active secondary insurance, simply isn’t found, providers are missing out on full revenue capture, further straining their resources.

This is, quite simply, unsustainable from the standpoint of operational efficiency. It’s critical for billers to be equipped with integrated revenue cycle management (RCM) optimization tools to help them submit clean claims and improve financial performance, so emergency medicine practitioners can continually improve their service levels.

Automated Tools That Reduce Workload and Increase Revenue Capture

Healthcare billing technology has come a long way. Market leaders have aggressively developed their solutions in recent years, adding significant depth and usability to tools that billers need to do their jobs effectively every day. For example, best-in-class billing, RCM, and practice management solutions can integrate tools that work seamlessly with existing technology and can automatically find, correct, and verify patient and payer information.