Discarded medical claims come from many sources. The most frequent is likely keystroke error. That is usually a reasonably easy fix and for our business it is also one that is easy to grab. The best method of catching some of these simple mistakes is to use a good scrubber for your medical claims.
Once the medical claims batch has been created, as it is processed through the mediator software, it looks for little unpredictability. Like an ending date that precedes a beginning date, just little things that can easily get entered out of succession when you are dispensation a lot of claims.
Another easy one to get erroneous is term date for actions and/or identification codes. Once you have used a code in your medical claims billing system, you should not be able to eliminate it because of the relational database algorithms. Repentantly, it is easy to use an old code without intending to. Again, this is where a good scrubber comes into play. It can catch those maddening errant codes before the claim gets out the door. By using the scrubber, you are able to rapidly get medical claims corrected, usually within a few hours, depending on how often you drop claims.
Issues with patient and health insurance claims information should be taken care of before you see the patient. I repeat, before you see the patient. Your obverse office should know in great detail the likelihood of whether you are going to get paid on this patient. They should have done all of their training by verifying each and every piece of information.
Some payers are predominantly irregular about not allowing more than one E&M visit in a day. Again, these are questions that can be enclosed prior to seeing the patient. Once it has been determined the patient may have previously seen another provider, the front office can check the insurance company and get the applicable rules.
Coding issues should be non-existent, as the provider and staff should have an in-depth knowledge of what is current, what supports what, and should any modifiers be used to clarify the claim.
Once the medical claims batch has been created, as it is processed through the mediator software, it looks for little unpredictability. Like an ending date that precedes a beginning date, just little things that can easily get entered out of succession when you are dispensation a lot of claims.
Another easy one to get erroneous is term date for actions and/or identification codes. Once you have used a code in your medical claims billing system, you should not be able to eliminate it because of the relational database algorithms. Repentantly, it is easy to use an old code without intending to. Again, this is where a good scrubber comes into play. It can catch those maddening errant codes before the claim gets out the door. By using the scrubber, you are able to rapidly get medical claims corrected, usually within a few hours, depending on how often you drop claims.
Issues with patient and health insurance claims information should be taken care of before you see the patient. I repeat, before you see the patient. Your obverse office should know in great detail the likelihood of whether you are going to get paid on this patient. They should have done all of their training by verifying each and every piece of information.
Some payers are predominantly irregular about not allowing more than one E&M visit in a day. Again, these are questions that can be enclosed prior to seeing the patient. Once it has been determined the patient may have previously seen another provider, the front office can check the insurance company and get the applicable rules.
Coding issues should be non-existent, as the provider and staff should have an in-depth knowledge of what is current, what supports what, and should any modifiers be used to clarify the claim.