Preparing Insurance Claims and Posting Insurance Payments

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Presentation transcript:

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

CMS-1500 Form Standard form used in medical offices

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

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

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

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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