CLIA Number Errors: A Major Obstacle to Revenue Cycle Success

​For practice managers, healthcare providers, and owners, denial due to Remark Code MA120—indicating a missing, incomplete, or invalid CLIA certification number—can be a significant hurdle in the revenue cycle. Such errors can lead to denied claims, delayed payments, and unnecessary revenue loss.

The Importance of CLIA Numbers in Billing
The Clinical Laboratory Improvement Amendments (CLIA) certification number is essential for laboratory test claims. It confirms that the lab complies with federal quality standards and is authorized to perform testing. Without this number, claims are automatically denied, disrupting your cash flow and leading to costly delays.

Common Causes of CLIA Number Denials
Several factors contribute to CLIA number-related denials, including:

• Invalid CLIA number: Using an outdated or incorrect CLIA number.
• Missing CLIA number: Forgetting to include the CLIA number on a claim.
• CLIA number not on file: The payer does not have the CLIA number on record.
• Invalid CLIA/procedure code combination: A mismatch between the CLIA type and the performed procedure.
• Service date prior to CLIA certification: Providing lab services before obtaining the CLIA certification.
• Terminated CLIA number: The certification has expired or been revoked.
• Provider information mismatch: Discrepancies between the CLIA number and the NPI or TIN.
• Technical glitches or errors: System issues or mistakes in data entry.
• Incomplete claim information: Missing or inaccurate data on the claim form.

Mitigating CLIA Number Denials
Preventing CLIA-related denials requires diligent practice management and adherence to the following best practices:

• Verify CLIA number accuracy: Regularly update your CLIA number to ensure it’s accurate and current.
• Ensure accurate data entry: Double-check claims to prevent errors, especially with critical details like CLIA numbers.
• Use electronic claims submission: Streamline your process to minimize manual data entry errors.
• Stay current with CLIA regulations: Regularly review CLIA guidelines to ensure compliance with the latest standards.
• Invest in denial management systems: Use software to monitor denial trends and implement corrective measures.

Partner with Claims Med for Revenue Cycle Success
Addressing CLIA number errors is crucial for maintaining a healthy revenue cycle. Claims Med offers comprehensive revenue cycle management services to help you minimize denials and maximize reimbursements. With expertise in handling CLIA-related denials, we can help your practice recover revenue and enhance overall financial performance.

Contact Claims Med today to discover how we can support your practice in overcoming denial challenges and optimizing your billing operations.

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