Hold Claims

When your practice needs to prevent certain claims from being submitted, you can create a claim hold. A claim hold prevents claims from going out for specific dates of service, billing providers, places of service, and insurance plans.

You can use PCC's tools to work on claims with errors, rejections, and denials. But what if a problem is fixed, but the claim wasn't resubmitted? Or what if an insurance payor simply never responds? Are some insurance payers regularly failing to pay you in a timely fashion? You may need specialized tools to track and work down your practice’s insurance A/R.

When insurance carriers send payment and adjustment information, either on an EOB or an ERA, they often include a code with a small message. These codes are known as CARC values, or Claim Adjustment Reason Codes, and they are an industry-wide standard.

Every insurance claim in Partner has a unique identification number. The number appears in various Partner reports and programs, and you can use it to improve claim tracking and payment posting.

Learn how to submit claims in PCC EHR or in the previous Practice Management tool.

Partner's insurance billing tools help submit claims, review rejections, and work down your insurance accounts receivable. Partner helps you maximize the use of your time as you pursue proper insurance reimbursement.

While most claims are transmitted to payors electronically, sometimes you may need to generate a paper 1500 HCFA form.

How is a claim created, and what happens in the background to make sure your practice is paid? Read below to learn some of the "under the hood" workings of claims after you post charges into PCC EHR.

PCC automatically checks insurance eligibility for all of a scheduled patient's active insurance plans, if the carriers support automated eligibility. You can use eligibility features in PCC to review and confirm eligibility for upcoming appointments. You can also review and re-check a patient's insurance eligibility status during Patient Check-In.

The medical biller's job would be easier if accounts paid on time and insurance companies reimbursed the correct amount. Unfortunately, accounts build up balances and credits and insurance companies overpay, underpay, and demand "takebacks."

After you bill a visit in PCC EHR, you can return to the patient chart and review what was sent to the checkout program.

Use the Billing Configuration tool to configure billing behaviors of procedures and diagnoses and the Billing screen in PCC EHR. Follow the procedures below to open the Billing Configuration tool and make changes.

Your practice can bill for phone calls and portal messages. Read this article to learn how to chart and bill for a phone encounter (or portal message thread). You'll also find configuration instructions and tips for turning phone calls and portal messages into billable telemedicine encounters.

Use this new user training outline to learn how to complete billing tasks in PCC.

You can quickly and easily reconcile payments that your practice has posted in PCC EHR. Run the Payment Reconciliation report in order to prove out, checking against your cash drawer and records at the end of the day or the end of your shift. Open the Payment Reconciliation report from the Report Library in PCC […]

As you post charges, you can review and update patient information (like insurance eligibility), double-check the linking and codes that the clinician selected, and post any payments received.

Learn how to schedule, chart and bill a telemedicine visit with PCC.

Read this article to learn about configuration options and implementation recommendations for the Post Charges features in PCC EHR.

Your pediatric practice renders so many services in a day that it can be difficult to keep track of every last item that needs to be billed. Read this article to learn the different ways to find charges in PCC EHR that need to be posted.

Learn how to post a forms fee or any other administrative charge that could occur outside the context of an appointment.

Read this procedure to learn how to create a hospital encounter on a patient's chart, post hospital diagnoses and charges, adjust claim information, and queue up a claim.

You can review all of a patient's billable encounters in the Billing History section of a patient's chart.

You can review payment history by encounter, or see all payment history for an account. You can also edit personal payments that were posted incorrectly, or that are linked to the wrong charges.

You can print a receipt whenever you post a payment. You can also print a receipt for any payment(s) in an account's history.

After you prepare and submit claims, you must deal with claims that could not be submitted or were rejected.

What kinds of pre-submission processing does your PCC system do on claims? What errors can it find, and how do you fix them?