Getting Creative With Claims Advice

Efficient Medical Electronic Billing Claims Submission to Avoid Denials

Electronic medical billing has greatly improved the way claims are processed and paid, but this does not mean that the task is very easy to do. However, with proper training and practice, electronic submissions can be maximized efficiently for trouble-free submissions. The benefits of electronic medical billing has benefitted the healthcare industry in many ways. With electronic medical billing, insurance pays claims within 3 days which is a lot shorter compared to around 3 weeks for paper billing. With this system the possibility of errors and lost claims are significantly reduced. There is full encryption of transmissions and it is compliant with HIPAA rules and guidelines.

If you have an electronic medical billing system in your facility, it is important that you sign up with a clearinghouse that charges a reasonable monthly flat fee regardless of how many claims you can submit and resubmit. Don’t pay anything other than the monthly flat fee. Full compliance with HIPAA is also required for the clearing house. There is no trouble looking for a good clearing house to use for your electronic medical billing submissions.

The list of payors’ numbers with the insurances you bill and participate with should be included. ON the patient’s insurance information, the payor number identifies where your claims will go. Make sure that your tax number is in your billing system.

Enter your patient’s insurance ID number correctly. Don’t put any other characters in the insurance ID number aside from numbers only. Enter the insurance ID number without any asterisks or dashes.

Before filing your medical billing, you need to check if there is proper authorization or that you have verified the patient’s insurance coverage for that date of service.

When you use modifiers, make sure that you are using the proper ones. Electronic billing systems are intelligent systems that can easily pick up error. Make sure that you non-numeric modifiers are always in capital letters.

When creating your file, preview all claims. Before submissions, check for missing information. Make sure you edit the claims for errors before submitting.

After submitting he claims, generate reports. The report should indicate that the claims are accepted. When you see that the claim is rejected, immediately correct the claim by calling the insurance and resubmitting it. Make sure to read all your electronic submission receipts and reports.

Keeping track of your claims should always be done. If your system has a tracer tool, then it will be easy to keep track of your claims. You can track your pending and unpaid claims. You have to be persistent in following up denied or rejected claims.

If this task is too much for you and if you want to avoid the headache of following up on rejected claims, denied claims, and underpayments, then you can outsource your billing needs to an experienced full service medical billing company.

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