Today’s insurance payers have a variety of requirements, from specific forms to filing deadlines. It’s up to the practice’s biller and/or coder to ensure that the terms for each submission have been met.
Denville, NJ (PRWEB) November 13, 2013
“The first thing that clinicians need to do is implement an electronic medical record system,” said Chhoda. “It will make submitting claims and getting paid infinitely easier. There’s less chance of claims being rejected or denied with an EMR and it significantly reduces the wait time for funds to be deposited.”
He added that completion of the claim cycle used to take weeks and even months to complete. EMR technology has reduced that wait to 10 days or less, while allowing for real time claim submission. Today’s insurance payers have a variety of requirements, from specific forms to filing deadlines. It’s up to the practice’s biller and/or coder to ensure that the terms for each submission have been met.
Chhoda proposed the following steps during a claim cycle to ensure payment approval.
- Verify healthcare insurance information before the client arrives for the visit;
- Verify insurance coverage at the time of the visit to ensure it’s still in force and determine if there is a secondary insurance carrier;
- Secure a copy of the patient’s insurance card, identification, health history and payment consent form at the time of the appointment;
- Record all the client information into the EMR;
- Make sure to create a patient encounter form that will document all the diagnosis, procedures, treatments and services, and the appropriate ICD-9 and CPT codes;
- Compute the medical fees and be cautious to include a cost for even minor supplies such as bandages and swabs;
- Create a claim form that includes relevant information gathered from the patient and medical provider.
- Send the claim electronically with the EMR when applicable or with a paper copy by mail for those that haven’t employed EMR technology;
- Always make sure to receive confirmation that the claim is received, denied or contested;
- Resubmit the claim, additional information, or appeal the decision as required;
- Bill the patient for their portion of the debt.
The claim cycle process is facilitated by an EMR and Chhoda’s new checklist provides billing and coding specialists with the appropriate procedure to follow when utilizing EMR technology. Changes in forms, coding and submission requirements change with little notice. Chhoda’s data combined with an integrated EMR ensures clean submissions, few rejections and fees that are reimbursed quicker.
Chhoda’s office can be reached by phone at 201-535-4475. For more information, visit the website at http://www.emrnews.com.
About Nitin Chhoda
Nitin Chhoda PT, DPT is a licensed physical therapist, a certified strength and conditioning specialist and an entrepreneur. He is the author of "Physical Therapy Marketing For The New Economy" and "Marketing for Physical Therapy Clinics" and is a prolific speaker, writer and creator of products and systems to streamline medical billing and coding, electronic medical records, health care practice management and marketing to increase referrals. He has been featured in numerous industry magazines, major radio and broadcast media, and is the founder of Referral Ignition training systems and the annual Private Practice Summit. Chhoda speaks extensively throughout the U.S., Canada and Asia. He is also the creator of the Therapy Newsletter and Clinical Contact, both web-based services to help private practices improve communication with patients, delivery better quality of care and boost patient retention.