P2 Management Minute: Defeating payer denials
Slash claim-denial headaches in 60 seconds with quick fixes to decode, prevent and overturn payer rejections—boosting cash flow fast.
Hey there folks, my name is Keith Reynolds, I’m the editor of Physicians Practice and for today’s P2 Management Minute we’re focusing on defeating payer denials:
Tip 1: Understand the denial.
Start with the payer’s EOB or remittance advice. Note the denial code, date of service and procedure code, then confirm the patient was eligible that day and the service is covered. Finally, pull your charge slip and chart. Typos, missing modifiers or an off-by-one digit in a CPT code are the fastest route to a “no.”
Tip 2: Spot the repeat offenders.
Most denials trace back to the same handful of problems—wrong demographics, lapsed insurance, missing prior auth, lack of medical necessity or late filing. Track those patterns in your practice-management system; fixing the root cause today prevents tomorrow’s rework.
Tip 3: Act fast and document.
If it’s a simple clerical error, correct and resubmit. When medical necessity is questioned, add clinical notes or a letter of medical necessity. And never miss the appeal window—some payers close the door in as little as 60 days. Calendar the deadline the moment the denial lands.
Master these three steps and your denial rate—and stress level—will drop. For deeper dives, see the denial-management guides on PhysiciansPractice.com. Thanks for watching.
About the P2 Management Minute
The P2 Management Minute is a fast-paced video micro-series from Physicians Practice that distills proven management strategies into bite-size, one-minute episodes for busy medical practice administrators and lead physicians. Each installment spotlights high-impact tactics—drawn from real-world best practices and expert insights—that administrators can apply the same day to boost efficiency, strengthen patient satisfaction, or elevate staff engagement. No theory, no fluff; just concise, actionable guidance that respects tight schedules and delivers measurable results between appointments.
Record your own!
Interested in stepping in front of the camera to share a quick tip of your own, or have a suggestion for a topic we should spotlight in an upcoming P² Management Minute? We’d love to hear from you. Whether it’s a proven strategy for streamlining workflows, a clever morale-booster, or a hard-won lesson on patient engagement, your insight could help peers across the country elevate their practices in just 60 seconds. Drop Keith a note at kreynolds@mjhlifesciences.com with your idea—or, better yet, a brief outline or smartphone video sample—and we’ll walk you through the simple submission process. Let’s collaborate to make every minute count for the medical community.
Keith A. Reynolds is the editor of Physicians Practice and wants to know what practice issues are keeping you up at night. You can let him know at kreynolds@mjhlifesciences.com.
