Electronic Claims Submission

ABC submits all claims electronically within eight hours from the encounters or charges received time. Electronic claim submission speeds up claim processing in medical billing. The clearinghouse provides a confirmation that the claims have reached the payer on time. Electronic claim submission reduces rejections and denials drastically. ABC submits claims electronically to almost all clearinghouses and familiar with the clearinghouse portals. Many payers have very strict claim filing time limits. Electronic claim filing helps to stay on time and enhance cash flow. Before the claims are submitted the following checks are made

  1. Appropriate modifiers are added to the CPTs
  2. High specificity diagnosis are added by cross-checking the progress note
  3. Reminders sent to providers before electronic claim submission if the claims are created without the completion of progress note

Clearinghouse Rejections and Batch Checking

Clearinghouse generates payer acknowledgment and rejection reports for every claim batch submitted. These reports are analyzed line by line and erroneous claims are fixed and resubmitted. These reports help us to improve operational efficiency. Electronic claims submitted are commonly scrubbed for the payer, specialty, and coding rules. ABC works on rejected claims immediately and resubmits them with required corrections. After submitting the claims electronically batches are checked in the clearinghouse portal to confirm if the claims are accepted by the payer and clearinghouse.

Medical records request and submission

  1. Medical records requested by the payer are downloaded directly from the hospital portal rather than relying on the practice

  2. Medical records are submitted directly through the insurance portal to save time 

  3. All worker compensation claims are submitted with medical records in the first submission

  4. Separate invoices are created for attorney offices requesting medical records. Medical records are sent after the payment received from the attorney offices

  5. Weekly reminder sent to the provider to complete unsigned medical records