Leaving even one required field on a claim form blank can trigger a denial. An incorrect member ID, demographic error, or a missing Social Security Number can cause an immediate medical billing denial.
Duplicate Service or Claim
Duplicates are claims resubmitted for a single encounter by the same provider on the same date for the identical service.
Not Insured by the Payor
If a patient had a procedure that is not covered under the patients’ current plan, it can lead to a denial. You can prevent this by double-checking the patient’s insurance eligibility before delivering services.