What Is Denial Code 164?
Denial Code 164 indicates that the claim attachment was either not received or was submitted after the payer’s deadline. This seemingly minor issue can result in frustrating delays and lost revenue. Understanding the why behind this denial is key to stopping it from recurring.
Why Timely Attachments Get Missed: The Root Causes
Here are the most common reasons practices experience Denial Code 164:
- Human Error: A simple oversight or lack of training on payer-specific attachment rules.
- Communication Breakdowns: Missed hand-offs between providers, billing teams, and payers.
- Tech Glitches: System errors during electronic submission.
- Incomplete or Illegible Docs: Poor-quality scans or missing info stalls processing.
- Non-Compliance: Not following unique payer guidelines for documentation formats or submission timing.
How to Stop Denial Code 164 From Affecting Your Bottom Line
1. Streamline Document Management
- Use a centralized digital system for storing patient documentation.
- Perform weekly audits to ensure attachments are complete and accessible.
- Digitize everything—eliminate physical document bottlenecks.
2. Double Down on Pre-Submission Checks
- Create checklists for payer-specific requirements.
- Include all supporting documents at the time of claim submission.
- Use a pre-submission review process with dedicated staff or AI tools.
3. Strengthen Communication Channels
- Train staff on clear, efficient interactions with payers.
- Maintain direct lines for claims queries.
- Set up automated follow-up reminders post-submission.
4. Leverage Smart Tech
- Integrate EHRs with claim software to pull attachments automatically.
- Use claim scrubbing tools to catch missing attachments.
- Implement document management software to speed up workflows.
Partner With Claims Med for Smarter RCM
Timely and accurate submissions are critical to getting paid on time. At Claims Med, we specialize in preventing avoidable denials like Code 164 by optimizing every step of your revenue cycle. Our tech-enabled services and hands-on support mean fewer delays and more revenue in your pocket.