When it comes to electronic claim filing, there can be a lot of questions to answer. Often times, we think we know the best way to go about a certain process when in reality there is a much more efficient way to do what we are already doing. When we do this, we are essentially tricking ourselves into thinking this is the best solution. But, wouldn’t you rather treat yourself to a more efficient process? I thought so! Follow along as we go electronic claim filing trick or treating!
Trick: An OD doesn’t need to get involved in claim filing, that’s the biller’s job.
Treat: It’s good to delegate, but being too removed is risky. After all, Claims = Money. In the end, providers are responsible for the claims, not the biller.
We’re talking money and liability here. It’s worth it to stay in the loop! What would happen to your practice if you lost your biller, and couldn’t fill the position for a month or two? That may sound DRAMATIC and unlikely, but could the practice sustain operating costs without having a system to manage electronic claim filing that keeps claim reimbursements coming in? If the answer is no, then you have a good reason to know the basics!
Plus, if the practice gets audited, guess who’s under the microscope? Not the biller! It’s the provider who has to answer the tough questions. Could you answer them?
Claim filing is a crucial part of a practice’s success, so providers need to know what’s going on. Not only will it help in the instance of “Claim Filing drama”, but it will also help to make sure that the biller’s needs are understood and that the staff has the tools they need to get the job done.
Trick: A Claims Clearinghouse is a waste of money since payers have their own sites.
Treat: Comparing Payer Sites to a Clearinghouse isn’t apples to apples. That would be like saying there’s no reason to have electricity in your house when you’ve got candles.
Don’t waste time and energy. Going to multiple sites means learning multiple systems, and keeping up with the complexities of each. Clearinghouses give you one place to manage everything; it doesn’t get any easier!
Accessing all of the Payer Sites you may file to means creating accounts on each one, for each employee in your practice using it. Your staff will also have to remember how to use each site’s varying functionality, and know how to train others to use them. Talk about a lot to keep up with!
Good claims clearinghouses are affordable and offers a ton of value. They aren’t free, but they are worth the money because of all they have to offer. You get all this when you use a clearinghouse:
- Thousands of payers in one location
- Patient eligibility verification
- Claim submission and tracking
- Secondary claim processing
- Detailed reporting and analytics
- Claim uploading from practice management systems
- Electronic remittance advice (ERA)
- ERA Auto-Posting in compatible practice management systems
- Training and customer support for the life of your account
Trick: The internet is a scary place where bad things happen. It’s too risky to file claims online.
Treat: First of all, the internet is awesome! Second, your staff probably has the internet on their phone anyway. Third, you can restrict access and customize security settings.
Stop being scared of online claim filing! This is one that still shocks us. The insurance industry has a lot of skin in the game in terms of making sure that online claim filing is secure. Do you think that they would allow claims to be filed online if the risks were too high? That’s a big no.
So what about a clearinghouse? How can you be sure that they are “safe”? Well, clearinghouses have the same compliance responsibilities as the payers. The information that is entered into an insurance claims processing system and processed is secure. And, you can customize your account settings within a clearinghouse so that your staff only has access to the information they need. It doesn’t have to be a free-for-all!
Same goes for the internet access in your practice. You can set your browsers so that only certain sites are accessible. You don’t have to deny yourself, and your practice, the benefits of electronic claim filing because you want to control internet use in your practice.
Trick: Online claim filing is only good for big practices with a lot of claims.
Treat: eclaims are preferred, if not fully mandated by most payers, regardless of the size of your practice.
Face it; payers are replacing more and more of their old processes with technology solutions to make their work easier – even as you read this.
So, if you’ve been filing claims with a payer and they aren’t requiring you to use an electronic method, those days are numbered. Before long, paper claims will be a thing of the past and everything will be done electronically. That day will be here sooner rather than later.
Sure, filing electronically makes things easier if you’ve got a large claim volume because the efficiencies compound. But that doesn’t mean that the same benefits aren’t there if your volume is lower. Why deal with difficult processes for a handful of claims when you could eradicate those difficulties altogether? We can’t think of a good reason.
Jeepers creepers! That’s some tasty information you just devoured. These tricks and treats are just a few excerpts from a recent eBook published by VisionWeb titled Claim Filing Fantasy vs Fact. Click the button below if you’d like to read the entire eBook that debunks common myths about claim filing.