The submission of insurance claims is one of the most critical steps in the medical billing practice. In conventional terms, the claim submission procedure entails the healthcare practitioner filing a claim for reimbursement to the insurance payer. The reimbursement to the healthcare provider is contingent on the correct insurance claim submission.
As previously stated, it is a vital stage in medical billing, which means it takes time to do correctly. As a result, the insurance claim must be error-free, meet the standards of the payer, and submitted on time.
The steps will ensure that the healthcare provider’s claim is processed quickly and their payment is received on time failure to comply may result in claim denials, refusals, late payments, or loss of income.
For all this, we get to know why outsource your medical billing. “Clean claim percentage” refers to the average percentage of first-time claims paid satisfactorily. Medical claims billing services allow you to keep this percentage level high to run a profitable healthcare practice.
BellMedEx Medical claims billing services
As healthcare costs continue to increase, healthcare practitioners wants to get timely and complete reimbursements on the patients bills.
One of the utmost prevalent approaches is to use medical claims billing services. These services will review your physician’s notes and bills and provide a quote for how much it will cost to complete your claim. As one of the best claims processing companies BellMedEx provides the necessary experience to suit clients’ needs from various industrial verticals. We provide short turnaround times for claim filings and frequent processing. We provide the following essential insurance claims processing services:
Examining the Patient’s Eligibility
If the patient’s eligibility is confirmed before the date of service (DOS), this will lead to more precise claim submissions and fewer claim rejections. By enhancing patient care and lowering write-offs, this eligibility authentication approach also helps healthcare practices maintain a healthy cash flow. This stage calls for the declaration of co-pays, deductibles, insurance effective dates, and other restrictions.
Claim form Filing
The claim form contains details on the Patient’s health and the operations rendered. Additionally, it indicates the extent to which the client’s insurance policy can reimburse the costs. The personnel at BellMedex Healthcare can aid you in filling out the claim form with the required details:
- Patient’s personal information
- Coverage of insurance policies
- Patient’s previous data
- Healthcare provider information
- Prior payments
Submission and Review of Claims
After entering all the claim information, our team will make a backup copy of all forms and papers. We will meticulously examine the information and make any necessary adjustments. We submit the claim form to the insurance after completing all the details and attaching all the compulsory credentials. We provide the necessary experience to suit clients’ needs from various industrial verticals. Our staff handle the filing of claims and the daily processing of claims as quickly as possible.
Claim adjudication
Claims are undoubtedly the essential source of data for any healthcare practice. These vital data are essential for risk management and the integrity of healthcare practices. BellMedex comprehends the need for hasty, correct claims adjudication; we provide a solution designed to deliver accurate and complete original healthcare claims management assistance, including administering encounters submissions backed by patient medical data. Through our expertise, we deliver detailed and comprehensive medical claims submissions and auxiliary patient treatment data in HIPAA-compliant and EHR forms. As needed, we can additionally accommodate a variety of registered medical claims submission formats. Our claims processing system provides an audit trail that stores records of a patient’s current and historical transaction data.
Payment Collection
The first step is to collect a cataloged bill from the healthcare provider that details the services delivered to the Patient and the cost and applicable code for the treatment. BellMedex Healthcare’s crew will support you with collecting the required correspondence and invoices.
How BellMedex helps you to achieve a high claim submission rate
Here are some quick points BellMedex medical claims billing services provided to accomplish a high clean claim rate.
Maintain Current Patient Information on Claims
The clean claim is mainly reliant on patient demographic information. Updated patient records are critical for providing quality healthcare to your patients. The Patient’s health records and details must be current to achieve the outcome.
Checking that patient information on claims is current is crucial as a result.
Before filing claims, a reliable medical billing firm like BellMedex carefully analyzes data such as insurance policy specifics, patient demographics, and medical information.
Manage Pre-Approval Requirements
BellMedex reduces previous authorization-related denials, resulting in fewer claim denials and increases cash flow for healthcare practices. We also use the best technology for reliably capturing pre-authorization information on the front end and allowing your billing staff to timely measure. This guarantees that the healthcare provider receives timely feedback.
This stage involves validating the procedure category, determining whether procedures require prior authorization, and determining whether the patient plan covers the procedure.
Stay Updated on Medical Coding Regulations
Insurance claim denials and rejections are the most significant obstacles to medical payment. It is simply too complex for healthcare providers to keep up with medical coding guidelines and standards.
Outsourcing the claim submission process to the best medical billing firms will help you remain on top of all medical coding changes, ensuring that your claims are tagged accurately before submission. Claim denials are frequently the result of improper coding or late claim submission. In this case, the claim scrubbing procedure immediately finds and addresses coding issues before submission by outsourcing BellMedex medical claims billing services.
Healthcare practices can also leverage the automation process for claim submission to handle claims faster by installing the best cloud-based EHR. To ensure coding compliance; this level requires the verification of ICD and CPT compatibility and the type of submission mechanism, whether paper-based or electronic patient record.
How Does Electronic Claim Submission Speed Up Your Claim Process?
Correct Modifiers for Claim Submission
If Healthcare practices fail to recognize a modifier appropriately, claims may be rejected. In addition to verifying that the modifier has been applied correctly, you must also verify that the process has been modified. Outsourcing medical billing services to BellMedex will assist you in rectifying all these issues.
Conduct quality assurance tests to verify clean claims
BellMedex does a worthy practice to undertake quality checks to ensure that claims are submitted correctly during the medical billing process. Demographic inaccuracies, medical coding errors, and errors that arise throughout the submission process are all instances of information that are validated by our professional staff.
Keep Up-To-Date Medical Records
Effective RCM can help minimize any issues with claim processing and reimbursement by utilizing a well-documented medical record. Some experts claim that full reimbursement is contingent on precise medical documentation. The Patient’s prescription history, procedure documents, case history, and other medical records need to be verified to expedite claim processing. This is accomplished through our competent experts’ medical claims billing services.
Why Choose BellMedex For Medical Claim Billing Services?
Reduce Time-Consuming Operations
It is time-consuming and impossible to automate the printing and filling out of manual paperwork. Your medical billing organization may produce electronic claims in a fraction of the time with automation techniques that diminish inaccuracies. BellMedex practically and instantaneously submits these error-free claims. This will lead to fewer errors and equal fewer claim denials, which may enhance your cash flow.
Reserves Resources
Creating and submitting handwritten medical claims costs a significant amount of front-office personnel time, not to mention a postage budget. These conditions and etiquette do not apply to BellMedex electronic claims. So it is possible with BellMedex medical claims billing services to save money by abandoning manual processes to submit electronic claims.
When double-checking claims, even the most skilled medical billers, and coders are prone to claim submission errors. Practice management software is far more precise; eradicating all those errors leads to insufficient claim submission. BellMedEx fully automated claim scrubbers detect claim mistakes and mark them for rectification before payer submission.
Integrated Clearinghouses
Mailing claims to payers introduces a slew of potential delivery issues. Your claims could be misplaced or sent to the wrong address. Instead, the BellMedex integrated clearinghouses that power the online medical billing process deliver your claims exactly where they need to go in seconds.
Accurate AR Recovery
You know that accounts receivable (AR) and their recovery hold a substantial amount of the practice’s potential revenue. You’re also presumably aware of the difficulties of keeping proper accounts receivable records. Because our proficient electronic claims accelerate reimbursement and the pathway for all claims, they restructure, simplify, and improve all features of AR.
BellMedex Mend the Proficiency of Your Healthcare Claims Management Practices
BellMedex medical claims billing services professionals strive to provide our clients with accurate and thorough encounter data. When we detect a recognized risk or delay in the medical claim, we promptly work to determine the root cause, undertake analysis, and provide resolution under applicable standards. We are professionals in gathering, analyzing, and reporting healthcare claims data because of our proven technological advancement in claim management capabilities. Our claims adjudication team can swiftly detect and address issues with inappropriate service utilization and service quality.
Outsourced medical claims billing services to BellMedex provide customized and complete claim submission integrated with electronic claims submission. With our electronic claims submission services, medical billing businesses often require only your patients’ basic information and a summary of the Patient’s historical data. Therefore, it is easier to create accurate and coded claims. We will run all processes with the help of a claim scrubber to ensure accuracy and proficiency before sending them to payers.
The Final Verdict
In addition to being critical, submitting a claim takes considerable time. As we all know, clean claims result in speedier reimbursement. What is the best way to achieve this? Your clean claim rate will go up, your overhead costs will go down, and your practice revenue will increase if you outsource claim filing to a reputable medical claims billing services provider like BellMedex. The BellMedex always assists you in streamlining your daunting task and modifies all issues as your practice grows.
Outsourcing medical billing like BellMedex claims management solutions assists you in managing your internal claims processing. That can increase security, lead to fewer claim denials, and faster billing turnaround time. Many healthcare facilities rely on our services to streamline their workflows starting from scratch.
