After the appointment the rendered services to patient are coded into codes which are either sent to insurance company electronically or printed on claim form and sent to insurance company in order to reimburse the services. It contains following entities:-

  • Charge entry: Codes are feed into practice management software to create either electronic or paper claim.
  • Claim Scrubbing: If claim has a minor error like missing information, it is notified while creating electronic claim and process correction of errors is claims scrubbing.
  • EDI Management: When claim is sent to insurance companies to capture major errors a system called as Clearing House is used at provider’s and payer’s system, so claims rejected by clearing house are corrected and worked under EDI management.

 

Our experience with shows that Tracking a poorly presented claims across all its operational levels and that too when its managed by multiple non-linear systems becomes a daunting task and therefore invariably becomes costly.

 

Even getting a simple answer to a basic question like, ‘Did we service this claim?’ requires a lot of time consuming manual research. Therefore to meet the above constraints, We at Findmedicalbillers.com will transmit electronic claims, where possible and if the insurance company doesn’t accept electronic claims, we will print the claim and mail it to the insurance company.

 

Thus within 24 hours we can generate audit of the electronic submissions made, as Our billing software gets audit reports from the clearing-house and has a mention of omissions or errors if any in the claims. Also we continuously monitor & Track unpaid claims and it’s resubmission when necessary. Moreover we do coordinate and take up any issues with the insurance company to assess the claim status IN CASE of not receiving an EOB at the end of 30 day period from the last billing date.

 

Our Claims Submission Services

Error free Processing Charge entry data entry At Findmedicalbillers.com, we guarantee accurate data being used so you can be confident of having the correct information each time when you deal with a patient.

Efficient Claim Scrubbing

It does away the many areas that trigger in excluded or held back claims submissions. With a system managed service, Findmedicalbillers.com can confirm ICD-9 codes, and perform other authentications to ensure speedy processing by the insurance companies with no delays.

Pre-adjudication

This takes care of claims denials and saves time while resubmitting claims. It can assist to determine which services calls for payment and to what extent will the payment come up to

System Managed Claims Submission

Making use of our secure billing structure, we do the submission of all medical billing claims to the insurance companies in any geography as carried out by our practice management system. Such claims can be go for submission either directly or through electronic clearing house. However there is one more option, as we do submissions of paper claims as & when required by our clients.

Denial Management

Moreover we know that no claim is less significant of the other , so rejection reports, if any, are fixed and resubmitted to ensure that all information are accurate, while ensuring that submissions are done in a timely manner.

EDI Management

This is an vital constituent of healthcare claims processing to manage data that is handled electronically for eg : claims forms and other paperwork. This safeguards the privacy of personal and sensitive information including the receipts of all essential paperwork done so far.


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