Billing Medical Claims Electronically

We have finally reached the stage where most offices are billing at least some of their medical claims electronically. But the more important question is, are they reading their electronic reports?

Just sending the claims in electronically is not enough. If you are not reading the electronic reports, then you are losing money. It is crucial to your practice that these reports are being read and being read regularly. If you say you don't have time to be checking the reports, then I say that you don't have time NOT to check the reports.

The first report that comes back when you submit the claims electronically lets you know if the batch made it to the clearing house. This is pretty important because you don't want to loose a whole batch of claims that will affect your cash flow. Interruptions in the phone lines or lots of other things can cause a whole batch to get kicked out.

Another report will tell you if the insurance company is accepting the batch. This report will let you know if any individual claims have errors causing them to not be submitted. An example of this is when a claim is dropped for an incorrect ID# or no longer a member with that insurance carrier.

Their are many advantages to billing electronically at this stage. If you are a provider who is seeing the patient regularly, such as a chiropractor or a psychologist, you find out much sooner than you would by filing on paper that a patient's coverage has changed. You can ask the patient on the next visit if the insurance information has changed - before you've billed them for six visits and they all were denied.

If you are a billing service and must keep track of many providers electronic reports, it is crucial to keep an electronics log. Next month we'll explain how we set up our electronics logs for 50 providers.

Copyright 2007- Alice Scott