How Improper MPN Denials Impact Providers and How to Resolve Them

Workers' compensation billing comes with its share of challenges, and improper MPN (Medical Provider Network) denials are among the most frustrating. For healthcare providers, these denials often mean delayed or unpaid claims, increased administrative work, and significant revenue loss.



At Medrina Technology Management, we understand the complexities of MPN denials and help providers resolve them effectively to recover payments they deserve.

What Are MPN Denials?

An MPN denial occurs when a workers' compensation payer rejects a bill on the grounds that the provider is “not part of their Medical Provider Network.” MPNs are established by employers or payers to control medical costs and ensure injured workers get care within a designated network of providers.

However, MPN denials are often improper and can arise due to:

• Incorrect MPN listings on file.
• Payer errors when identifying a provider’s status.
• Lack of updated provider information during claim submissions.
• Miscommunication between the payer and claims administrator.

The Impact of Improper MPN Denials

For healthcare providers, improper MPN denials can lead to:

1. Delayed Payments: Legitimate bills are left unpaid, creating cash flow issues.
2. Increased Administrative Burden: Time and resources are wasted chasing down corrections and filing appeals.
3. Lost Revenue: Without aggressive follow-up, unresolved denials can lead to permanent revenue loss.
4. Frustration: Providers treating injured workers may feel penalized despite meeting treatment requirements.

How Medrina Technology Management Resolves MPN Denials

At Medrina, we take a proactive and thorough approach to resolving improper MPN denials. Here’s how we help:

1. Verify MPN Status: We confirm the provider’s MPN status through official directories, claims administrators, and EAMS (Electronic Adjudication Management System) to build a solid case for appeal.
2. Appeal Improper Denials: Our team files detailed reconsideration requests, providing supporting documentation to prove network compliance or address payer errors.
3. Correct Billing Submissions: Incorrect or outdated provider information can trigger denials. We review and correct submissions to ensure accuracy before resubmitting claims.
4. Follow-Up Until Payment:  Denials don’t stop us. We pursue claims aggressively, ensuring payers process them correctly and release payments without further delay.
5. Education and Prevention: By identifying recurring denial trends, we help providers implement preventive measures to avoid future MPN-related rejections.

A Real-World Success Story

One of our clients, a busy orthopedic clinic, faced repeated MPN denials across multiple workers' compensation claims. Bills worth over $200,000 were rejected, stalling their revenue.

After partnering with Medrina Technology Management:

• We verified their correct MPN listings and filed reconsiderations for all improper denials.
• Within 60 days, 35% of the rejected claims were paid.
• The clinic saw an immediate boost in cash flow and a significant drop in MPN-related denials
• moving forward.

Why Partner with Medrina Technology Management?

At Medrina, we specialize in resolving complex workers' compensation billing issues like MPN denials. When you work with us, you get:

• Expert Resolution: A team with deep knowledge of workers' compensation regulations and MPN requirements.
• End-to-End Support: From verification to appeals and follow-ups, we handle it all.
• Faster Payments: We resolve improper denials quickly, so you don’t wait months for payments.
• Tailored Solutions: Every practice is unique, and we customize our services to meet your specific needs.

Final Thoughts

Improper MPN denials shouldn’t stand in the way of your revenue. With the right expertise and a proactive approach, these denials can be overturned, helping you recover what’s owed.

At Medrina Technology Management, we ensure your workers' compensation claims are handled accurately, efficiently, and with the aggressive follow-up they deserve.

Ready to tackle improper MPN denials and maximize your payments? Let’s connect today.