Don't Let Certification Issues Block Your Claims: Take Control Now!

​Tired of claim denials with the cryptic code "B7"? You're not alone. This frustrating code often signifies issues with provider certification, leading to wasted time and delayed reimbursements. But fear not! This guide empowers you, the healthcare provider or practice manager, to conquer certification challenges and ensure your claims get paid.

Understanding the Culprits Behind B7 Denials:

• PTAN Problems: The Provider Transaction Access Number (PTAN), your unique ID, might be inactive for the service date. This could be due to delayed enrollment, expiration, or administrative errors.
• Credentialing Errors: Incomplete or inaccurate credentialing information, such as missing licenses or certifications, can trigger denials.
• Billing Provider vs. Rendering Provider Discrepancies: Inconsistent information between the provider billing for the service and the provider who actually rendered it can cause issues.

Turn the Tide on B7 Denials with These Proactive Steps:

• Verify PTAN Validity: Before submitting claims, confirm your PTAN's active status through the National Provider Enrollment (NPE) Contractor website. Ensure it's valid for the specific service date.
• Maintain Updated Credentials: Regularly review and update your provider's credentialing information to guarantee accuracy and completeness.
• Accuracy is Key: Double-check that billing and rendering provider information is correct and consistent across all claims.
• Know Your Payers: Familiarize yourself with the specific credentialing and enrollment requirements of each payer you work with.
• Act Fast: Address claim denials promptly to minimize reimbursement delays.

The Cost of B7 Denials:
Claim denials due to certification issues can significantly impact your practice's finances. They lead to:

• Delayed or denied payments
• Increased administrative burden
• Potential revenue loss

By understanding the common causes and proactively addressing them, you can significantly improve claim accuracy and financial well-being.

Ready to minimize B7 denials and maximize claim reimbursements?  Claims Med can help!  Our team of experts can streamline your credentialing process, ensure accurate claim submission, and navigate appeals if needed. Contact Claims Med today and reclaim control of your revenue cycle!