SpectrumBillings

From there, the account may require a different action.

A claim with incorrect information may need correction and resubmission. A denied claim may require an appeal. A pending claim may need payer follow-up. A secondary claim may need to be submitted after the primary payer processes the account.

Spectrum Billings reviews these situations individually instead of treating every unpaid balance in the same way.

The Most Common Causes of Aging Accounts

Healthcare practices often see similar issues behind their unpaid balances.

Insurance Eligibility Problems

Incorrect or outdated insurance information can cause claims to be rejected before they are properly processed. Verifying eligibility and coverage information can help reduce these problems before submission.

Coding and Documentation Errors

A mismatch between the procedure, diagnosis, documentation, or payer requirements can result in a denial. Coding review helps identify errors that may prevent appropriate reimbursement.

Delayed Payer Follow-Up

Some claims require repeated communication with insurance companies. If no one monitors the claim after submission, it can remain unresolved for an extended period.

Unworked Denials