How do most of your health claims travel? Are they still going by paper? How can you track that system? With few exceptions, our claims all go by an electronic method. Most go directly from us to the payer, but a few filter through a clearing house.

Early this week, WellCare alleged that some 27 claims that were dropped out of our system on September 2nd were not on file in their system. Had we sent those claims by paper there would be little we could do. These are recent claims so if they had gone by paper, we could get them back out the door. Fortunately for us though they did not go on paper. Wednesday I had my IT pull the report for that day's drop (it is transmitted back to us the next day). When we reviewed the report, low and behold, all 27 claims were listed as accepted by WellCare and gave a batch number for the claims as well as a tracking number for each claim. The review itself is just as easy. Once the file is located, a quick easy search using the software looking for that specific provider instantly located the claims in 29 pages of report. These tools simply are not available using paper.

Regardless of the outcome, we are able to demonstrate that the claims were sent, and that WellCare received our claims. The medical billing people have done their job.

How good is your office about tracking claims? If you do not have a system in place for keeping up with when the claims went out, when they were received and who got them, you are wasting valuable resources. Take advantage of all the resources available to you. Teach your staff to work smarter, learn to use the system to your advantage rather than allow the insurance company to hoodwink you.


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