Electronic claims technology has been around for quite some time now. Filing claims electronically is simply sending a "paperless" claim to an insurance company over the internet or over phone lines from your computer and a modem. Sending electronic claims is HIPAA compliant and secure. As health care reform continues, it will soon be mandatory to file claims electronically. Aside from being ahead of the game (before it is mandatory) here are a few reasons to start submitting electronic claims today:
1. Faster turnaround time - when your claims are mailed it takes days to get to the insurance company and then it is added to a stack that has to be entered by hand by a claims processor. During peak times of the year, especially the end of the year, there is often a backlog of claims to be entered, which can result in delays that could result in weeks before your claim is processed.
Sending claims electronically significantly decreases turnaround time on claims processing. Especially if the claim is sent in real-time, the claim is received by the insurance company as soon the claim is transmitted. Real-time claims provide the status of an adjudicated claim within seconds of submission. This is confirmed by receipt of an actual Explanation of Benefits (EOB), which can be printed and provided to the patient at the time of service.
2. Improved Cash Flow - Faster claims processing means faster insurance reimbursement. The sooner the insurance company receives the claim, the sooner the payment is issued to the provider. Even better, many insurance companies offer electronic funds transfer (EFT) which gets the money in your pocket much sooner than receiving a check in the mail.
3. Increased Productivity - Sending insurance claims electronically allows you to run your business more efficiently without wasting money on unnecessary expenses. Filing claims electronically is a quick process which reduces hours required from staff allowing them more time to focus on what you value most, patient care. Sending electronic claims also reduce postage, printing, and paper costs associated with paper claims method.
4. Reduction in Errors - When filing claims electronically, the clearinghouse will alert you to missing or invalid information at the time of claim submission. You also will receive confirmation when the claim is received. Additional messages are sent as claims are processed. It is advantageous to be advised of these alerts and communications as they occur versus waiting for a rejected claim by mail.