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How to submit a successful medical billing claim

In a perfect world, every billing claim we filed would be without error and our reimbursements would be returned correctly and on time. This is the process we all strive for, yet too often we find claim-filled errors and incorrect payments flooding our inboxes. This is something we’re all too familiar with, but it doesn’t mean you’re failing at your job. In fact, there’s a good chance you’re doing everything you’re supposed to. Errors often come down to a couple of things: billers aren’t reviewing their data carefully enough and providers aren’t collecting the proper information at the start of an appointment. The good news is, these things can be fixed! To make your job simpler, we put together a list of steps you can take to submit successful claims every time. 

Ask the right questions up front

The first step of the process is often where too many providers slip up. When a patient arrives for their appointment, providers ask a series of demographic questions along with insurance questions including payer and policy number. But if a crucial piece of information is left out, or an incorrect policy number is given, you’re already on the path to a denied claim. Verifying correct information is a huge part of setting yourself up for billing success. 

Verify insurance eligibility

Insurance information can change at any time. You never know when a patient may have switched providers, so it’s always important to confirm the insurance payer and policy number before an appointment. Additionally, a change in insurance could mean a change in benefit coverage. Avoid a hassle down the line and verify the coverage up front. 

Submit the correct medical codes

Medical coders are responsible for taking the service a patient received and turning it into a specially coded language for insurance payers. Coding is a tedious job, and like other aspects of the billing process, one slip up can change the outcome of the claim. Making sure your coders are carefully checking their data ensures the claim will be sent off to the insurance companies accurately. 

Follow payer guidelines

When it’s finally time to submit your claims, make sure you check to see if the payers have any particular guidelines you’ll need to follow. Additionally, make sure you follow all state regulations for a seamless submission process. You’ve been careful to follow every step perfectly up until this point, and you don’t want to make an avoidable mistake right at the end. Keeping a list handy of your usual payers’ guidelines and remembering to check on the expectations of any new payers will keep your claims clean and your business looking good. 

Medical billing software makes billing even simpler

Even the best medical billers make mistakes now and then. But when mistakes pile up, they can become costly for your business. Medical billing software makes submitting error-free claims a breeze! The best part? It’s affordable, easy to use, and it saves your business money. Interested? Send the Claimgenix team a note today to book your personal software demo!

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