Medical Billing and Paper-Based Claims Made Easier

Through these past couple decades the digital space has sunk its teeth into every business and practice imaginable. Various software and tools aid in streamlining the administrative duties of most practitioners and eliminating human-errors.

It’s no secret that majority of medical billing is done through electronic claims processing deeming paper billing redundant but some claims deem paper billing necessary.

This lengthens the process and requires great attention to detail as the room for error widens with no software/tool to aid and flag errors.

Following are a few tips for accurate paper medical billing :

CMS-1500 or UB -04 USING THE DESIGNATED FORM

CMS-1500 is a universally adapted claim form used by private practitioners and non-institutional healthcare providers. CMS-1500 contains every bit of basic information needed to submit an accurate claim. The form includes fields for patient demographics , various medical codes specific to diagnosis and treatment along with insurance details . Different payers might often provide different instruction on how to appropriate fill certain details meaning the billers and coders need to be familiar with every specific requirement while filling out the form.

UB-04 form is particularly marked for use by hospitals and institutional healthcare providers for medical billing claims. Usually containing the same patient demographic and insurance specific details. It needs to be accurately filled by the biller and coder to avoid re-submission of said claim.

BILLING FORMAT

An improperly drafted bill will most likely end up as a denial of claim reimbursement. When drafting a bill, adhering to the general guidelines is vital for easy submission and swift payment.

Avoid highlighting any information on the claim
Ensure the printed format is correctly drafted for accurate data entry
A strict no to writing any sort of comments or notations on the form outside of the fields.

ACCURATE DATA-ENTRY

Data needs to be checked and re-checked before the submission of said claim form to avoid unnecessary delays or denials during the filing of claim forms.

Familiarity with insurance payer guidelines to understand the data requirement
Enter the insurance information exactly as stated on the insurance card with no alterations
Accurate diagnosis codes and procedural codes with the application of modifiers whenever necessary
Inclusion of NPI information wherever deemed necessary.

PROPER DOCUMENTATION

Proper documentation is an integral part of the claim filing process. Submission of a claim without required documents may result in delay and even denials. The claim form might require you to attach various documents:

Complete itemized statement
Medical records
EOB (Explanation of benefits) for the primary payer
Explanatory documents containing proof of incident or injury

CLEAN CLAIM SUBMISSION

A clean claim is self-explanatory in itself.
A claim that is void of defects and improprieties including incomplete documentation.
Billers and Coders need to be consistently accurate during the entire process, treating the form and the complete claim submission with great importance.
An error on the biller’s end will come back to effect the practitioner in the form of a delay or denial.

Billing and coding services provided by Bikham offer you medical billing solutions, streamlining your entire process of claim submission and ensuring swift claim reimbursements.
We are a team of certified billers with years of experience working with both electronic and paper-based claims.
Billing troubles getting out of hand?
Give us a call at +1-800-940-4943 and see how we can help !