Reducing the time to collect payment is the primary means of increasing revenue and cash flow. Using HIPAA electronic transactions can significantly streamline the insurance collection process.
Electronic Submission (837 Professional and Institutional) versus US Mail
Although sending claims electronically is now common, it is important to point out how electronic claims have improved the process of collecting payments efficiently.
In the past, claims were mailed to the payer. The claim waited for the mail to be picked up and sent through the postal service and finally delivered to the payer where the claims were sorted and distributed to employees charged with evaluating the claim and approving payment. All paper claims were reviewed manually for errors and incomplete information. The time elapsed could take up to several weeks.
With electronic filing, you send your file directly to the payer or to a clearinghouse. The payer’s computer system reviews the claims for missing information or unmatched subscribers. The status of your claims can be viewed online. With a good practice management system, the claim status is posted to the claim and if errors were found, immediately worklisted for follow-up. The process to check a claim for errors is reduced from weeks to a few days.
Electronic Status Requests and Responses (276/277)
Days pass and payments have not been received. Prior to electronic status requests, your staff would have to call the payer to inquire about the status of the claim. Waiting on the phone for this kind of follow-up wastes hours of time.
With electronic status requests, you can electronically send a status request and get an immediate response. You will know immediately if the payer did not receive the claim, the claim is being reviewed, the claim is being paid or the claim is denied. The time to obtain the status of a claim is reduced from hours to seconds.
With PiMS (Patient Information Management Systems) you will have the ability to use HIPAA transactions to increase productivity and cash flow.
View demos of PiMS at the website
http://www.pdmsoftware.com
You will see a complete practice management system, with complete HIPAA supported transactions.
Linear Mode
