The Human Causes of Insurance Claim Denial

Insurance claims failing to go through can be one of the most frustrating things to deal with today. Health expenses are crippling to most Americans, and insurance is a necessity to dealing with them. At times, especially under less expensive insurances, expenses will simply not be covered. Although 27% of the time denial is due to simple registration and processing issues.

These cases are due in very large part to human error. While technology can make mistakes, especially in identifying photos of insurance cards, most mistakes are human. These mistakes tend to happen in a few key categories. The first is in missed information. Many insurance cards don’t actually feature all the information to submit a full claim. Even when they do, it can be challenging to interpret with different locations and card formatting.

The second category of mistakes comes in payer location. Many large insurance companies have state or municipal specific localities. A claim submitted to the wrong locality is subject to complete claim denial. And the third and final category is in simple mistyped claims. These are especially common when cards aren’t screenshotted and are entered manually. 

And those are the major human causes of insurance denial. They’re all realistically avoidable, but they still happen everyday. The key in avoiding them is being aware and careful. Information must be entered and checked rigorously. Information that isn’t immediately available but also be carefully obtained and double checked. Insurance claims can make or break the bank, so it’s not something to rush into.
Learn more about insurance card capture with AI in the infographic below:

The Smarter Way to Capture, Verify, and Process Insurance with an AI-Powered Solution
Source: OrbitHC