Insurance Billing (Advanced Training Session)

When you receive a rejection, or you have a claim or billing problem, how do you correct the encounter information and then resubmit the corrected claim? Read this article to learn how to update and resubmit a claim.

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.

The Smart Report Suite (srs) is a report library in Partner. srs contains dozens of powerful reports, all with a consistent interface. If you learn to run one srs report, you will have learned to run them all.

The inscoar report provides a detailed charge-by-charge accounts receivable for your insurance companies. You can use inscoar to find insurance charges that have not been paid and to work down old, overdue charges. In addition, interactive inscoar is a great work environment from which you can research billing history, make changes, and resubmit claims.

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.

You can review and confirm patient insurance eligibility in either PCC EHR or in the Partner practice management system. This article teaches you how to use Partner's eligibility program to review status for upcoming appointments.

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."

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 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.

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