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

You might think that because medical billing has gone electronic, there will be no more problems experienced with it. 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. The benefits of electronic medical billing has benefitted the healthcare industry in many ways. Compared to paper billing which takes weeks to complete, electronic medical billing take only around 3 days to process and reimburse payments. The accuracy percentage is almost perfect so errors and lost claims are reduced. Encryption is done with submissions and HIPAA rules and guidelines are followed.

Your healthcare facility should choose a clearing house that charges a flat monthly fee regardless of the volume of your submissions and resubmissions. Don’t pay anything other than the monthly flat fee. Choose a clearing house that complies with HIPAA rules and regulations. You can find many of these clearing houses where you can submit your claims electronically or through a modem directly from your computer.

Make sure that you list down all of the numbers of your payor that you bill and participate with. This payor number will identify where your claims will go based on the patient’s insurance information. You should also include your tax number in your billing system.

Enter your patient’s insurance ID number correctly. Simply put the numbers without any other characters. Don’t use asterisks or dashes in when you enter this information.

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.

Preview all the claims when creating the file. Check for missing information before submitting your file electronic ally. Claims should be edited so that there will be no errors. Then submit your file.

Make sure that reports are generated right after submission. Ensure that the claims are accepted. IF the generated report says that the claim is rejected, immediately call the insurance company, then resubmit your claims. It is very important to read all your electronic submission receipts and reports.

You should always keep track of your claims. 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. 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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