Which of the following is essential for reducing claim denials?

Improving patient demographics collection is essential for reducing claim denials because accurate and complete patient information is critical for the claims processing workflow. When patient demographics, such as address, date of birth, insurance information, and guarantor details, are properly collected and recorded, it minimizes discrepancies and confusion that can lead to claim rejections. Insurers rely on accurate information to determine coverage, eligibility, and payment responsibilities, so if there are errors in the demographics, claims may be denied for insufficient information.

Accurate demographics ensure that the healthcare provider can bill the correct insurance plan and receive reimbursement for services rendered. Furthermore, many claim denials are often as a result of missing or incorrect information about the patient, so this practice directly addresses one of the most common issues in billing and coding processes. This proactive approach not only helps in obtaining timely payments but also builds stronger relationships with patients and insurers by ensuring clarity and accuracy.

In contrast, using generic codes, submitting claims without supporting documents, and not verifying insurance coverage before submitting a claim can all lead to increased denial rates. These practices do not address the root cause of claim rejections, which often stems from inaccuracies or lack of information concerning patient demographics.