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Guide to Efficient Submission of Medical Billing Claims

Although we have benefited from using electronic medical billing, we should not think that the task is a simple one. But, if you are trained and if you practice the ways to efficiently maximize the use of electronic submission, then it will ensure that your claims submissions will not encounter any hindrances. There are many benefits of using electronic medical billing. It will take a shorter time to process and reimburse payments compared to paper billing which takes weeks to complete. With this system the possibility of errors and lost claims are significantly 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. You should not pay any other fees on top of that flat fee. Full compliance with HIPAA is also required for the clearing house. You can find many of these clearing houses where you can submit your claims electronically or through a modem directly from your computer.

It is important that you have all the list of payors’ numbers with the insurances you bill and participate with. This payor number will identify where your claims will go based on the patient’s insurance information. Make sure that your tax number is in your billing system.

When you enter your patient’s information, make sure to have the patient’s insurance ID number entered correctly. 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.

Proper modifiers should be used. Since electronic systems are intelligent systems, every error is easily picked up. Capitalize all non-numeric modifiers.

Preview all the claims when creating the file. Check for missing information before submitting your file electronic ally. Make sure you edit the claims for errors before submitting.

Generate reports upon submission. Make sure that your claims are accepted. When you see that the claim is rejected, immediately correct the claim by calling the insurance and resubmitting it. 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. You will know if your claims are still pending or still unpaid. 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.

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