Phone

+1 786 656 0356

Email

hello@optumrcm.com

Location

KLLG st, No.99, Pku City, ID 28289

Top Reasons Claims Get Denied — and How to Prevent Them

Claim denials can severely impact a practice’s revenue if not addressed promptly. At OptumRCM, we help healthcare providers identify denial patterns and implement preventive strategies.

Common Reasons Claims Get Denied

  • Inaccurate patient demographics
  • Missing or invalid CPT / ICD-10 codes
  • Lack of prior authorization
  • Timely filing errors
  • Insurance eligibility issues

How OptumRCM Helps Prevent Denials

Our denial prevention strategy includes:

  • Clean claim validation before submission
  • Payer-specific billing rule checks
  • Ongoing coding audits
  • Root-cause denial analysis

Importance of Denial Management

Denied claims must be corrected and appealed quickly. OptumRCM ensures every denial is reviewed, corrected, and resubmitted within payer deadlines.

Final Thoughts

Preventing denials improves cash flow and reduces administrative burden. With OptumRCM as your RCM partner, practices can achieve higher collections and long-term financial stability.