3 Things Every Practice Should Know About Electronic Claims Filing

Posted by Tenzin Yulo on Thu, Jun 06, 2013 @ 08:06 AM

For the longest time, eyecare practices have gotten used to the routine of collecting patient information and then mailing in claims, one-by-one. Smart practices have noticed the huge amount of time this takes away from concentrating on patients. To help get you on the path to efficiency, check out these 3 things that every practice should be aware of when it comes to filing insurance claims electronically.


1. Using a Clearinghouse is the Next Step Towards Efficient Electronic Claims Filing

These days, eye doctors have multiple options to send in claims. You can file claims yourself by sending them through the mail or by visiting each individual payer's website. You could also hire an outside billing service to handle your claims, but many people feel like they lose control when they do it that way. The last option is to use a clearinghouse company that connects multiple insurance companies in one location.

There are many advantages to using a clearinghouse, including:

  • The ability to submit to thousands of payers from one website
  • The ability to enter leads in directly on the clearinghouse website or through integrated eyecare practice management software
  • Systematic error checking, which makes it less likely to be rejected when submitting your claims
  • Being able to track insurance claim status in real time

As you can see, using a clearinghouse gives you the ability to maximize reimbursements, receive payments faster, identify and correct claim problems sooner, and generally takes the headache out of claim filing. Even better, clearinghouses with ERA management services make the claim filing process even easier, which brings us to our second point.

claim-filing2. Use an Electronic Claim Filing Service with ERA Management

When it’s comes to electronic claim filing services, you want to look for a service that makes your life as easy as possible, right? If that’s the case, you should be looking for a claim filing service that also offers ERA management, or Electronic Remittance Advice management services. Using a clearinghouse with ERA management services will give you the ability to automatically interpret remittance advice received from your payers – information typically received on paper – and deliver it in an electronic format.

Remittance advice in an electronic format is much easier to manage than stacks of paper EOBs. And it’s accessible in a fraction of the time, so you can start the reconciliation process sooner. Using an electronic claim filing service with ERA management will also give you the ability to:

  • Search and sort remittance information by provider, payer, date range, check number, or payment method
  • View summary reviews with reasons for adjustments, denials, and reductions
  • View transaction-level and claim-level summaries
  • Export your reports into an Excel format for easy remittance advice archiving
  • Download and import ERA into your compatible practice management system
  • Have access to software for auto-posting 

Clearinghouses offer a number of services and benefits. We highly recommend you check out our post, “Don’t Commit to a Medical Claims Clearinghouse Before Reading This”, before making a purchase decision on a service.

3. Sending Claims Through the Mail Simply Won't Cut It Anymore

Old habits may be hard to break but we're in the 21st century! Claims sent through the mail can take days to receive, which means it will take even longer to get back your reimbursement payments. Even worse, they could get lost in the mail! A simple switch to electronic claims filing will provide better and more efficient care of your customers. In addition, rejected claims will be returned faster with reasons as to why the claim was rejected so this mistake won’t happen again. This way you’ll be able to see more patients instead of wasting time dealing with claim rejections.

Furthermore, errors in paper claims can’t be caught until after the entire process is complete. This will delay the time it takes to get paid for the claim, and it takes up to 30 days for the entire process to be completed, which unfortunately could leave your patients upset. Can you afford to spend time filing claims on paper?

What are you waiting for? Download our quick efficiency test to find out if you're getting the most out of electronic claims filing! 

Download the Claim Filing Efficiency Test

Tags: Tips & Tools, Electronic Claim Filing

Looking for tips to grow your eyecare practice business? Read on!