You thought Electronic Submission of Claims do not make any mistakes or error? You are absolutely wrong. It sometimes has glitch that you did not realize you have overlooked.

I have seen medical offices who ONLY relies on the Verification report. Well, this is a report being generated after you send your claims electronically. It usually shows you a "pass" or "reject" claims on the report. The truth of the matter is, based on my experience, I can not rely on these verification reports alone.

Getting on top of your Response Report is more essential than just relying on your verification report. What is this called "Response/Return Report"? This is the report that will show you every insurance company's reply or response for all the claims that were submitted to the clearing house and has been received successfully by the insurance payer. Each patient with its date of service will show you "accepted", "adjudicated", "received" payer status report. This is actually your real response report. This is where you can determine if your claims actually reached the insurance payer!

Bottom line, you should see two reports when you submit your claims by electronic, one for verification/confirmation/summary of the claims and the second report which usually takes after 2-3 days would be the Response/Return/Status Report on which it will actually tell you if the claims were received by the insurance payer.

When your claims get denied for untimely filing and your system shows you have submitted the claim electronically. The insurance company will require a PROOF. What proof are you going to give them?

Your Proof is the "response report" that indicates "accepted" or "received by payer". If you don't have this proof. There is no way you can appeal your claim. And your physician will not be happy for not being paid for the services he rendered to his patients.

So be very careful on this. It's important you pay attention on these reports.


Article Source: http://EzineArticles.com/?expert=Pinky_Mcbanon