Submission of claims is a vital process for healthcare providers and practices. A failure to maintain a higher clean claim rate hampers the revenue flow. This makes ensuring error-free medical claims essential.

However, the road to accurate claims and their submission has various challenges. Healthcare providers must avoid these complexities and improve the medical billing process. Only then, they can uplift their revenue cycle management and improve the operational flow.

This article highlights the proper steps for submitting error-free medical claims. Continue reading to explore this topic and implement the same in your healthcare practice.

Easy Steps to Elevate Your Clean Claim Rate

Here are the steps to maintaining error-free medical claims:

Medical claim inaccuracies are the primary cause of denials and revenue losses. However, following some simple steps can prevent healthcare providers from experiencing disruptions in efficient revenue cycle management.

Accurate Patient Information  

The first step in ensuring error-free medical claims is recording correct and complete patient information. This is a common medical billing challenge that leads to denials.  

Healthcare providers must reduce manual errors and avoid missing important details.  

For this, they must incorporate effective tools like Electronic Health Records (EHR) and avoid errors in patient information.

Proper Prior Authorization

Not all treatment procedures are a part of a patient’s insurance policy. So, it becomes necessary for healthcare providers to check insurance policy details. Before a patient visits, the healthcare provider must obtain prior authorization.

Ignoring this vital step can result in claim denials and affect the financial position of healthcare providers and practices. That is why healthcare providers must not miss out on this step. They also partner with medical claim billing services to get this done by professional medical billers.

Adherence with Coding Guidelines

Errors during medical coding are also a major contributor to claim denials. Coding guidelines can be challenging to follow. This increases the chances of translation and claim filing errors.

Healthcare providers must rely on qualified medical coders specific to their medical specialty. This helps keep up with coding guidelines and maintain coding accuracy.

Outsourcing medical claim billing services gives healthcare providers access to expert medical coders and billers. They further help healthcare providers and practices deal with complex coding.

Use of Right Modifiers

In the race to meet CPT and IDC requirements, healthcare providers overlook modifiers and their importance in boosting revenue. So, healthcare providers must prioritize modifiers before filing and submitting claims.

They need to ensure correct utilization of modifiers, preventing claim denials. Medical billing services are skilled in medical claims, and they make sure every modifier is right.

Review Before Claim Submissions

The last step before submitting claims is reviewing the claim and performing a quality check. This means healthcare providers must recheck all elements of their claims before submission. From patient registration to documentation, coding, and claim filing, healthcare providers must cross-check the accuracy of every step.

Certified medical coders and medical billers are proficient in handling a review checklist. They ensure accuracy to achieve error-free medical claims.

Final Thoughts  

Implementing accuracy and efficiency is crucial to acquiring an error-free medical claim process. Healthcare providers can streamline their revenue cycle management if they take care of the given steps. However, outsourcing medical billing services is the most convenient method to improve the claim submission process.

Eminence RCM helps healthcare providers and practices navigate through complex medical billing. They enhance the accuracy of vital billing steps, reduce coding errors, and scrutinize claims before submission. They also make sure to follow regulatory standards and denial management, assisting healthcare providers in achieving adequate revenue.

At Eminence RCM, client needs are first offering them tailored medical billing services. So, partner with them and upgrade your claim submission process.