Time is Money

Creating Clean Claims The First Time Around! Here are four tips for making sure your claims are clean and that your payments are processed and rendered the first-time around:

1. Technology

Two ways to expedite the payment of claims right off the bat is to file electronically and sign up for EFT (Electronic Funds Transfer).

Looking ahead, there will be increased use of technology for:

• Contracting
• Claims Payment
• Benefit Quoting
• Electronic Medical Records

2. Correct Data Fields

Common reasons for claims denials include:

• Invalid Diagnosis Code / CPT code
• Invalid member identification numbers – Inaccurate information
• Incomplete information: make sure patient name, address, insurance id numbers and group numbers are valid. 

3. Deadlines

Make sure a claim is submitted to the insurer within the permitted time-frame which can be as short as 90 days from DOS.

Many insurers don’t consider a claim to be received for processing until all information is complete and accurate making the need for submitting correct information up front all the more important.

4. Denied Claims

If a claim is denied, do the legwork and respond within a week of its receipt. That way you still have a good chance of receiving payment in a timely fashion.

For more information, please contact Sheetal Shah, Director of Billing, American SurgiSite Centers at sshah@americansurgisitecenters.com.