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Check for missing claims data before filing.

Your software should check to ensure that no data elements are missing from your claims submissions. It is not uncommon that claims filing is delayed or submissions are denied because the form does not include some minor piece of information (e.g., the referring provider's name or some patient demographic information). (1)

The software program represented in the figure has identified several data elements that were not included in charges entered via a handheld electronic superbill device. (2) This workfile should be completed daily by the individual who is responsible for your practice's billing. The software audits each claim, notes any missing data, and forwards the claim to the work file with an explanation of what is missing.

[FIGURE OMITTED]

When a biller communicates missing data elements to the rest of the staff at staff meetings, the result is improved office efficiency. Gradually, the percentage of clean claims filings should improve until it is rare to see a claim held for submission because of the omission of a minor data element.

References

(1.) Isenberg SF. Clean claims are key to timely reimbursement, but be vigilant. Ear Nose Throat J 2002;81:88.

(2.) Isenberg SF. Electronic "superbills." Ear Nose Throat J 2002; 81:439.

Dr. Isenberg is an otolaryngologist in private practice in Indianapolis; sisenberg@good4docs.com
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Title Annotation:Practice Management Clinic
Comment:Check for missing claims data before filing.(Practice Management Clinic)
Author:Isenberg, Steven F.
Publication:Ear, Nose and Throat Journal
Article Type:Brief Article
Geographic Code:1USA
Date:Aug 1, 2003
Words:217
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