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Overwhelmed by the Complexity of Medical? This May Help


How to Avoid Claims Denials and Rejections of Your Medical Electronic Billing

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, it is still possible to have trouble-free submissions if there is proper training and good practices to use electronic submission efficiently. There are many benefits of using electronic medical billing. With electronic medical billing, insurance pays claims within 3 days which is a lot shorter compared to around 3 weeks for paper billing. The accuracy percentage is almost perfect so errors and lost claims are reduced. Transmissions are also fully encrypted and it is compliant with HIPAA rules and guidelines.

Choose a clearing house for your healthcare facility that will charge you a monthly flat fee for all your submissions and resubmissions no matter how many you submit. Don’t pay anything other than the monthly flat fee. Choose a clearing house that complies with HIPAA rules and regulations. There is no trouble looking for a good clearing house to use for your electronic medical billing submissions.

Make sure that you list down all of the numbers of your payor that you bill and participate with. The payor’s number will indicate what insurance company pays for the medical claims and this is found in the patient’s insurance information. Make sure that your tax number is in your billing system.

You have to ensure that when you enter your patient’s information, the patient’s insurance ID is correctly entered. Simply put the numbers without any other characters. Asterisks and dashes should not be used.

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.

Use proper modifiers. Errors are easily picked up by electronic billing systems. Make sure that you non-numeric modifiers are always in capital letters.

When creating your file, preview all claims. Make sure that there is no missing information before you submit your claims. Claims should be edited so that there will be no errors. Then submit your file.

Generate reports upon submission. The report should indicate that the claims are accepted. Call the insurance and resubmit the claim if you see that it is rejected. when you generate receipts and reports, make sure that you read them all.

Claims should be kept track of. You have a powerful tool if you medical billing software has a tracer tool. Pending and unpaid claims can easily be tracked. If your claims are denied or rejected, follow them up persistently.

Outsourcing your billing needs to an experienced full service medical billing company is an option you can take if this task is too much for your facility to take and to remove the headache of following up denied, rejected, or underpaid claims.

What I Can Teach You About Claims

News For This Month: Medical