Claim denials in healthcare have been a great area of concern for healthcare providers. Most denied claims are unfortunately never fixed. So, it is critical to ensure the clean submission of claims. AR turnover rates depend greatly on filing clean claims. In this blog, we will share 5 steps involved in the claim submission process in medical billing.
Steps for Claim Submission Process in Medical Billing
You should follow the below 5 steps if you want to ensure clean claim submissions:
1. Correct Patient Information
The most common reason why most claims are rejected is the wrong patient information. Make sure that the patient information is updated regularly in the EHR. It should help you avoid errors in patient information.
2. A Stringent Authorization Process
Checking the coverage plan of a patient can be time-consuming, but an essential process. You must get prior authorization before scheduling a patient visit. The authorization should be obtained at least 5 days before offering the service. It will minimize the claim denial risks.
3. Follow the Current Healthcare Coding Guidelines
Coding guidelines in the medical field change regularly. Therefore, it is essential to stay updated with the most recent coding guidelines. This is the reason why it is always best to outsource claims billing in the healthcare field.
4. Use Right Modifiers
Different payers use different guidelines about modifiers. Before you submit a claim, it is essential to know the right modifier for claim submission according to the payer. If you don’t use the right modifier, the payer’s system will not recognize it. And, it will lead to claim denials.
5. Quality Checks
The final step in the clean claim submission process in medical billing is the quality check. During the quality check, it is important to reassess several things. Such things include patient demographics, modifiers and medical codes used, etc.
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