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. It will take a shorter time to process and reimburse payments compared to paper billing which takes weeks to complete. The accuracy percentage is almost perfect so errors and lost claims are 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. Aside from this monthly flat fee, no other payments should be made. 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.
It is important that you have all the list of payors’ numbers with the insurances 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. Your billing system should also include your tax number.
Enter your patient’s insurance ID number correctly. Don’t put any other characters in the insurance ID number aside from numbers only. 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.
Proper modifiers should be used. Errors are easily picked up by electronic billing systems. Capitalize all non-numeric modifiers.
Make sure that you double check the claims that you file. Before submissions, check for missing information. Make sure you edit the claims for errors before submitting.
After submitting he claims, generate reports. Make sure that your claims are accepted. IF the generated report says that the claim is rejected, immediately call the insurance company, then resubmit your claims. when you generate receipts and reports, make sure that you read them all.
You should always keep track of your claims. Medical billing software with a tracer tool is a system which is very powerful. You can track your pending and unpaid claims. If your claims are denied or rejected, follow them up persistently.
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.