7 Ways to Reduce Claim Denials in Your Medical Practice

Most practices treat claim denials as an unavoidable cost of doing business. In our experience running revenue cycle operations for dozens of practices, a denial rate above 10% is almost always fixable — and usually traces back to a small number of root causes.

1. Verify eligibility before every visit, not just new patients. 2. Audit your top five CPT codes quarterly for modifier errors. 3. Submit claims within 48 hours of the visit. 4. Build a dedicated denial-appeal workflow with a strict SLA. 5. Track denial reasons by payer, not just in aggregate. 6. Keep credentialing status current for every provider and location. 7. Review payer policy updates monthly — payers change requirements more often than practices realize.

None of these require new technology or headcount — they require a consistent process. That's the same process we run for every RCM client, and it's why our clients typically see denial rates fall by 40-60% within two quarters.