What are the Rules? Understanding the term ‘Small Provider’ As of October 16, 2003, The Administrative Simplification Compliance Act (ASCA) prohibits payment of initial health care claims not sent electronically, except in limited situations. The exclusion that applies to most doctors of chiropractic is the ‘small provider claims.’ CMS states: The word “provider” is being…
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Paper Claims Still Required by Some Some carriers must be billed on paper, such as Personal Injury and Workers’ Compensation claims. It is important that you have a standard operating procedure for printing bills. The entire process starts with a clean claim. If you do not submit a clean claim, payment may be delayed. Below…
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Not all payers accept electronic billing. Especially those Personal Injury or Worker’s Compensation payers. The process for billing is not different from electronic, other than all the “scrubbing” must be done by a human, not a machine. Understanding the process of sending paper claims correctly and efficiently will be a boom to your cash flow….
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Electronic Billing FAQs Q: Up to now our practice was cash only, but now we are credentialing with payers and we are ready to enter the world of electronic billing. Where should we start? A: Generally, a practice benefits greatly from a practice management software program. There are many different programs available, and they offer…
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Submitting Secondary Claims and Attachments Electronically Clinics can realize many benefits due to the advancement of automation in the health care industry. One such benefit is the ability to submit secondary claims and attachments electronically. Almost all payers can receive secondary claims and attachments electronically for pended claims. Because electronic secondary claims billing is a…
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How They Work Management software creates an electronic file (batch) for your claims. These files— also known as 837 files—are uploaded to a clearinghouse through your account. The clearinghouse searches, sorts, and scrubs claims checking them for errors and omissions. Once the claim passes scrutiny, the clearinghouse securely transmits the electronic claim to the specified…
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