Stop Denial Code 115: Boost Revenue with Proven Strategies

Denial Code 115 is a common challenge for healthcare providers, indicating that a procedure was postponed, canceled, or delayed. These denials can lead to revenue loss and administrative headaches. In this blog, we’ll explore the causes of Denial Code 115 and share actionable strategies to prevent it, helping you streamline your revenue cycle.

Why Does Denial Code 115 Happen?

Denial Code 115 can result from a variety of factors, including:

1. Patient-Related Issues
   • Health conditions or emergencies.
   • Failure to follow pre-procedure instructions.
   • Financial challenges, such as inability to pay deductibles or co-pays.
2. Provider-Related Issues
   • Scheduling conflicts or errors.
   • Lack of resources or equipment.
   • Insufficient documentation of medical necessity.
3. Insurance-Related Issues
   • Prior authorization requirements.
   • Coverage limitations or denials.
4. Facility-Related Issues
   • Equipment failures or power outages.
   • Unforeseen circumstances like natural disasters.

How to Prevent Denial Code 115

To minimize Denial Code 115 denials and improve your revenue cycle, implement these proven strategies:

1. Streamline Pre-Authorization
   Submit pre-authorization requests promptly and maintain detailed records of approvals.
2. Improve Patient Communication
   Clearly explain appointment details, pre-procedure instructions, and potential delays to patients.
3. Enhance Documentation Practices
   Document all reasons for postponements, cancellations, or delays, including supporting medical records.
4. Optimize Scheduling
   Use scheduling software to reduce conflicts and no-show rates.
5. Proactively Manage Risks
   Identify potential risks and develop contingency plans to minimize disruptions.
6. Train Your Team
   Educate staff on the importance of accurate scheduling, documentation, and communication.

Partner with Claims Med for Revenue Cycle Success

Denial Code 115 doesn’t have to derail your practice’s financial health. By adopting these strategies, you can reduce denials, improve cash flow, and focus on delivering quality patient care.

At Claims Med, we specialize in revenue cycle management solutions tailored to healthcare providers and practice managers. Our team can help you streamline processes, reduce denials, and maximize reimbursements. Ready to optimize your revenue cycle? Contact Claims Med today to learn how we can support your practice.