Denial Code CO 27, which indicates that services were provided after the patient’s insurance coverage had expired, is a common and frustrating challenge for healthcare providers. These denials result in unpaid claims, impacting your practice’s cash flow and potentially eroding patient trust.
Understanding the Root Causes of CO 27 Denials
Several factors can contribute to CO 27 denials:
- Inaccurate or Outdated Insurance Information: Incorrect or missing patient insurance details, such as policy numbers or effective dates, can lead to inaccurate coverage verification.
- Delayed Claim Submission: Submitting claims after the coverage end date will inevitably result in a denial.
- Lack of Proactive Eligibility Verification: Failing to verify patient eligibility and coverage status before providing services increases the risk of encountering coverage lapses.
- Communication Gaps: Miscommunication between the patient and the practice regarding changes in insurance coverage can lead to unexpected denials.
- Unexpected Policy Changes: Changes in the patient’s insurance policy, such as terminations or changes in coverage, may not be communicated to the provider in a timely manner.
Strategies to Prevent CO 27 Denials
To minimize the impact of CO 27 denials:
- Robust Eligibility Verification: Implement a robust system for verifying patient eligibility and coverage before providing services.
- Regular Insurance Updates: Regularly update patient insurance information in your practice management system.
- Timely Claim Submission: Submit claims promptly to ensure timely processing and minimize the risk of denials due to coverage lapses.
- Effective Communication: Maintain clear and open communication with patients regarding their insurance coverage and any potential changes.
- Utilize Technology: Leverage technology such as electronic health records (EHRs) and practice management software to streamline eligibility verification and improve data accuracy.
Partner with Claims Med for Revenue Cycle Success
Mitigating the impact of CO 27 denials requires a multifaceted approach. Claims Med offers specialized revenue cycle management solutions to help you:
- Minimize Denial Rates: Identify and address the root causes of denials, including CO 27.
- Improve Claim Accuracy: Enhance the accuracy of your claims submissions to reduce the likelihood of denials.
- Optimize Revenue Cycle: Streamline your revenue cycle processes and improve cash flow.
- Recover Denied Claims: Effectively appeal denied claims and recover lost revenue.
Don’t let CO 27 denials erode your practice’s revenue. Contact Claims Med today to schedule a consultation and discover how our expertise can help you optimize your revenue cycle and achieve your financial goals.