Claim Submission..

Whenever all charges related to a particular case are posted into the system, you can rest easy and let our team to handle the submission of the client’s electronic claims (including HCFA 1500 claims) to the respective payers. We can work on all the clearinghouse denials and give proper feedback with suggestions to reduce the number of claims that do not pass the clearinghouse. We also send detailed reports to you on a daily, weekly, monthly and yearly basis. We understands that your revenue stream needs to be steady, so we exercise due diligence in patient registration processes, minimizing the chance that claims will be denied and ensuring complete documentation for appealing denied claims. With Simplifyd Care as your partner, you can ensure all payments are collected in a timely manner and reduce your claims denials in order to improve your organization’s cash flow.

Once the charges are entered and audited, the claims are then filed with the payer electronically. We also have the capability to process paper claims. Usually at clearing houses, the claims go through some type of cursory filtering software to ensure that they are accurate and all information is contained within the document. Within 24 hours, a paper report is sent back with errors that have been caught. Once we have the report, the incorrect claims are rectified with the necessary information within 24 hours and the claims are resubmitted to the insurance company. Claims are submitted electronically via the practice management system. However, we can process paper claims also. At this stage, a thorough quality check is done by a senior billing specialist and then submitted. The rejection report received from the clearing house, if any, is analyzed and the necessary changes are done. These claims are then resubmitted.