1. Verify eligibility before every visit
A large share of denials trace back to coverage and eligibility problems that were knowable before the patient arrived. Verifying benefits and authorizations up front prevents them entirely.
2. Capture clean demographics
Transposed digits in a member ID or an out-of-date plan cause immediate rejections. Confirm and update demographics at check-in.
3. Code to medical necessity (LCD/NCD)
Align diagnosis and procedure codes with Local and National Coverage Determinations so payers see medical necessity the first time.
4. Use the right modifiers
Missing or incorrect modifiers are a top denial driver. A coding review before submission catches them.
5. Submit within 24 hours
Fast submission protects you against timely-filing problems and shortens your payment cycle.
6. Work denials within 48 hours
Denials age badly. Reworking and appealing them quickly — with documentation — recovers revenue that otherwise gets written off.
7. Track denial reasons
A denial-reason report turns one-off fixes into permanent ones. If a payer keeps denying a code, change the upstream process.
8. Don't ignore small balances
Small-dollar denials and credit balances accumulate. Working them consistently keeps your A/R clean and compliant.
9. Get expert eyes on your A/R
A specialized partner brings denial analytics and appeal experience most practices can't staff for. Synergy targets a 98% clean-claim rate and works denials within 48 hours. We can also clean up your old A/R.