Preventing Rising Claims Denials

3 Ways a PointofCare Charge Capture Solution Can Help Reduce Rising Claims Denials

Despite advances in technology and automation, insurers continue to deny healthcare claims at a higher-than-expected rate. According to a new analysis, inpatient denials increased by 18.5% in 2022 even as COVID was waning, rising to 4.2% of all inpatient dollars submitted for reimbursement. 

health insurance claims scrabble blocks

Medicare Advantage plans tended to have higher claims rejection rates than the average payer, denying 5.8% of inpatient claims due to level of care versus 3.7% on average.  

How can physician groups and other healthcare providers reduce their denials?   

1. Use revenue cycle analytics to determine why claims are being denied 

The right tools can help you standardize claims monitoring across the organization, with insights at the provider, practice, or location level – and with the accuracy your providers need. They can enable you to:

  • Monitor how long the revenue cycle takes from claims submission to payment 
  • Help speed claims submission 
  • Benchmark providers by total bills, encounters, length of stay, readmissions, and quality measures. 
  • Access dashboards to quickly gain insights that enable you to view and compare service quality and value metrics and share KPIs throughout the organization.  

2. Use point of care tools to capture necessary documentation and ensure claims are complete  

Denials increase when there is a lack of documentation specificity and supporting evidence for the necessity of the care delivered. Tools that make it easier to accurately and fully capture sufficient documentation about that care can reduce denials as well as the burden of data capture for physicians and other providers.  

mobile phone with Ingenious Med missing documentation icons

An effective charge capture solution should automatically confirm substantiating EHR documentation. To that end, Ingenious Med offers Charge Note Reconciliation, a feature that integrates with the EHR to automatically flag and assign bills that are missing the necessary documentation or charges. Charge Note Reconciliation includes: 

  • Visual alerts of missing notes for both administrators and providers  
  • Automatic identification and assignment of missing bills to providers when they create notes without corresponding charges 

3. Strengthen coding capabilities 

Accurate coding is a critical component of clean claims and revenue integrity. Using Ingenious Med, you can: 

  • Quickly flag any providers or locations that may have higher claims denial rates or who may be over or under coding. The tool enables you to consistently capture complex as well as simple charges across any acute or post-acute location 
  • Lighten clinician workloads with automatic prompts and intelligent code filters specific to each medical specialty 
  • Update codes as regulations and reimbursement levels change, to help prevent physicians from entering inaccurate or outdated codes. Certain specialties, such as family practice and orthopedics, are especially subject to frequent coding changes 

doctor on mobile phone

An effective charge capture solution should also: 

  • Track all patient care episodes via real-time census and appointment data feeds. 
  • Automate workflows to help ensure that an organization can produce all documentation required during a claims audit, preventing penalties caused by the inability to substantiate a charge. 

To learn more about how Ingenious Med can help with rising claims denials, give us a call at 770.799.0909 or visit