Filing claims electronically can offer a number of benefits, including:

• Minimize disruptions to your cash flow.
• Track claim status.
• Increase accuracy and cut down on claim rejections.
• Cut down on paperwork.
• Decrease overhead costs and staff time.

Electronic claims submission vs. manual claims submission An “electronic claim” is a paperless patient claim form generated by computer software that is transmitted electronically over telephone or computer connection to a health insurer or other third-party payer (payer) for processing and payment.

No, I don’t think so. Once he start submitting electronic claims, the physician itself may notice that his/her money and time will be spent properly. And because electronic claim is actually paperless, in this procedure there is an assurance of financial savings not only for the physician but also for the payers.

There are also several disadvantages of electronic medical records, such as: Potential Privacy and Security Issues: As with just about every computer network these days, EHR systems are vulnerable to hacking, which means sensitive patient data could fall into the wrong hands.

Two most common claim submission errors? Typographical errors and transposition of numbers.

Here are the top 5 reasons why claims are denied, and how you can avoid these situations.

• Pre-Certification or Authorization Was Required, but Not Obtained.
• Claim Form Errors: Patient Data or Diagnosis / Procedure Codes.
• Claim Was Filed After Insurer’s Deadline.
• Insufficient Medical Necessity.
• Use of Out-of-Network Provider.

5 of the 10 most common medical coding and billing mistakes that cause claim denials are

• Coding is not specific enough.
• Claim is missing information.
• Claim not filed on time.
• Incorrect patient identifier information.
• Coding issues.

Duplicate Claims Healthcare Finance News found that one of the most frequent sources of a claim denial has nothing to do with medical conditions or policies, but instead is the result of administrative mishaps by providers.

The claim has missing or incorrect information. Whether by accident or intentionally, medical billing and coding errors are common reasons that claims are rejected or denied. Information may be incorrect, incomplete or missing.

A rejected medical claim usually contains one or more errors that were found before the claim was ever processed or accepted by the payer. A rejected claim is typically the result of a coding error, a mismatched procedure and ICD code(s), or a termed patient policy.

When you buy auto insurance, you probably hope you’ll never get into an accident and need to file a claim. Unfortunately, insurance companies can — and do — deny policyholders’ claims on occasion, often for legitimate reasons but sometimes not.

State correct age, occupation, income and insurance coverage: Besides the health condition, you should also be completely honest about your age, occupation, income and other insurance cover. Your age defines the risk, so any inaccuracy can lead to rejection. If your work profile involves risk, give the true picture.

Call your doctor’s office if your claim was denied for treatment you’ve already had or treatment that your doctor says you need. Ask the doctor’s office to send a letter to your insurance company that explains why you need or needed the treatment. Make sure it goes to the address listed in your plan’s appeals process.

When your health insurance claim is denied, you can appeal the insurance company’s decision. Much like you would for other types of claims, you will review your policy, gather evidence to support your claim, write a letter and appeal the decision.

Things to Include in Your Appeal Letter

1. Patient name, policy number, and policy holder name.
2. Accurate contact information for patient and policy holder.
3. Date of denial letter, specifics on what was denied, and cited reason for denial.
4. Doctor or medical provider’s name and contact information.

Insurance companies have internal appeal processes for policyholders to appeal a decision that they think was wrong or unfair. Explain in your letter how your evidence contradicts the insurer’s decision. If an appeal is denied, you can file a complaint with your state insurance department.

Disputing their decision Calmly and politely is the best way to approach an insurance claim dispute. First, you can write a letter to the independent adjuster explaining why you believe their total settlement is not enough compared to what you calculated. Even if you’re upset, don’t demonstrate it.

How to Fight a Claims Dispute. If your claim was wrongly denied, the best thing you can do is to contact an experienced lawyer. He or she can review your options, such as asking the insurance company to reconsider based on new information or filing a complaint against the insurance company if it is acting in bad faith.

40 days

Most states protect consumers by demanding insurers handle the claims promptly. Some states even require a specific period, such as 30 days. During that time, the car insurer acknowledges the claim, investigates and makes a fair settlement. Not all states have a specific time limit.

Insurance companies often conduct claims investigations to evaluate the legitimacy of a claim. Insurance claims investigations rely on evidence, interviews and records to conclude whether a claim is legitimate or illegitimate. There are several types of insurance investigations depending on the claim being made.

Here are things that you should not say to an insurance company after a car accident: Don’t make any statements right after an accident. You may be in shock, confused, or stressed. Don’t admit fault.

Private investigators aren’t allowed to do anything illegal, which could include trespassing onto your private property, entering your home without your consent, hacking into your email or mobile phone, putting a tracking device on your car, or impersonating law enforcement officers.

An investigator cannot access cell phone records without a warrant or consent of the individual who holds the records. In most instances, a private investigator can get comparable evidence through other methods.

Check for strange vehicles parked near your house or places you frequently visit. If you see the same vehicle parked in your neighborhood, and you later see the same vehicle parked at the grocery store, the bank, your favorite restaurant or near your work, you might have an investigator watching you.

Video Surveillance Often, insurance companies will hire investigators to follow you while you perform your daily activities. This is legal as long as they are not infringing upon your privacy, meaning if you’re at work or in a supermarket parking lot, recording you is fair game.

Insurance companies may be able to use video footage to challenge the validity of someone’s claim. Some may even engage in bad faith insurance practices such as denying valid claims. Many insurance companies try to check traffic cameras for proof the accident did not happen the way the claimant says it did.