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Showing posts with the label Dermatology Biologic Claims

Should You Switch Billing Companies if Your Family Practice Denial Backlog Keeps Growing?

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A growing denial backlog is more than a billing department problem. For a Family Practice, it can mean delayed payments, increasing A/R, more staff time spent on rework, and revenue that becomes harder to recover as claims age. But a large denial backlog does not automatically mean you should switch billing companies. The better question is: Is your current billing company actually fixing the causes of denials, or is it simply working through the same problems every month? That distinction matters. The American Academy of Family Physicians (AAFP) recommends tracking denial rate alongside days in A/R and adjusted collection rate because these measures provide a clearer picture of revenue cycle performance. A practice can have acceptable overall A/R while still carrying a significant amount of older receivables. When Does a Denial Backlog Become a Serious Problem? Not every denial needs to be treated as a crisis. Some claims may require additional documentation, payer review, corrected c...

Why Are Dermatology Biologic Claims Facing Increased Denials in 2026?

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Dermatology biologic claims are facing increased denials in 2026 due to stricter payer policies, prior authorization requirements, documentation scrutiny, and evolving reimbursement guidelines. Biologic therapies are high-cost treatments commonly used for psoriasis, eczema, and other chronic dermatologic conditions. Because of their expense and long-term use, payers are applying tighter review processes, leading to more frequent claim denials and payment delays . Understanding these trends is essential for protecting revenue in dermatology practices. What Is Driving Higher Denials for Dermatology Biologic Claims? Several factors are contributing to rising dermatology biologic claim denials in 2026. Key drivers include: Stricter prior authorization policies Step therapy enforcement Limited formulary coverage Increased medical necessity documentation requirements Frequent policy updates by commercial payers Failure to meet any of these requirements often results...