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Preparing Insurance Claims and Posting Insurance Payments

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Presentation on theme: "Preparing Insurance Claims and Posting Insurance Payments"— Presentation transcript:

1 Preparing Insurance Claims and Posting Insurance Payments
Chapter 17 Preparing Insurance Claims and Posting Insurance Payments

2 CMS-1500 Form Standard form used in medical offices

3 Filing Claims Electronic filing Filing paper claims
Electronic data interchange & standards Clearinghouses ensure claims are complete and correctly formatted Filing paper claims Used in limited situations

4 Claims Tracking Method of monitoring outstanding claims
Electronic claims tracking Available with most practice management software Claims follow-up Electronically-submitted claims: after 3 weeks Paper claims: after 6 weeks

5 Insurance Payments Insurance payments are applied to a patient’s account, with any appropriate adjustment Payments are detailed on an EOB or RA

6 Billing Secondary Insurance
Secondary insurance is more common today with dual income earners in households Once payment is received from primary insurance, a new claim is created for secondary insurance Secondary insurance often pays the balance Attach a copy of the primary insurance EOB to the claim

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