Claim Submission Services
Are dynamic regulations, inaccurate documentation, or faulty coding impeding the seamless submission of an insurance claim in your healthcare practice? Look no further than our HIPAA-compliant claim submission services. Our skilled team simplifies and expedites the frequently intricate task of claims submission, minimizing claims denials to enhance the efficiency of your revenue cycle management framework.
Years of Experience
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Experienced Professionals
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How We Streamline Claim Submission Services for Your Practice
We maintain a perfect blend of cognitive intelligence and high-end billing tools to execute the entire insurance billing process with 100% accuracy and acceleration. This ratio drives our end-to-end claims submission services to maximize reimbursements while taking administrative burdens from your shoulders. Here’s how we do it:
- Integrate the billing software with EDI, EHR, EMRs, and your practice management system (PMS) to minimize data entry issues and ensure a smooth workflow for electronic claims processing and payments for accelerated payment cycles.
- Verify patient demographic details (name, address, physician referral, medical history), insurance information (coverage details, preauthorization requirements, effective dates, expiration dates, claims address), and other relevant details before submitting the claims.
- Handle the process of obtaining prior authorization for procedures required by certain insurance plans.
- Conduct real-time claims scrubbing to ensure the validity and accuracy of all procedural and diagnostic codes mentioned in the claims files before an electronic submission to the clearing house.
- Assign specialists with specific expertise in billing types, including value-based billing, telemedicine billing, capitation billing, and episode-of-care billing.
- Pay attention to the specificity of claims forms, such as using the CMS-1500 form to bill Medicare, Medicaid, and private insurance payers like Humana, Aetna, etc.
- Ensure accuracy of CPT codes, ICD-10 codes, HCPCS Level II codes, revenue codes, and modifiers to minimize claims denials or rejections.
- Dedicate a professional to overlook claims status inquiries. This person liaises between the payer and the healthcare company to follow up on the claims adjudication process. Identify and rectify any contractual adjustments mandated by the patient’s agreements with payers.
- Receive EOBs from payers furnishing comprehensive information of medical services covered and not covered by patient insurance. This document delineates service charges alongside coverage details.
- Resolve any disputes in claims submission and initiate an appeals process to ensure complete coverage for maximum reimbursement.
- Furnish clear and comprehensive reports delineating charges, authorized amounts, deductibles, copayments, and co-insurance for every patient. Notify patients about their payment responsibilities to prevent unpaid bills for our clients.
- Maintain accurate records of all claims-related transactions, including receipts, invoices, bills, and other relevant documents.
Our Comprehensive Claim Submission Services
- Patient Registration
- Insurance verification
- Coding & billing
- Claims scrubbing
- Claims submission
- Claims follow-up
- Accounts receivable management
- Payment Posting
- Denial management
- Appeals Management
Request a Quote
During your consultation, some of the issues we can discuss are:
- Challenges and inefficiencies of your current claims submission process.
- How do we ensure our procedures and services improve claims accuracy and submission efficiency?
- List of our services and their benefits to your business operations.
- How we adhere to the HIPAA, data security guidelines, and other regulatory requirements
Invensis - The Most Trusted Claim Submission Services Company
As a premier claim submission company, we have 24 years of experience maintaining strict adherence to the industry's prescribed guidelines for claims submission. Our clientele encompasses a diverse spectrum, including but not limited to hospitals, physician practices, insurance companies, third-party administrators (TPAs), and government agencies, among others. The services are executed by our team of multi-level experts such as claims processors, CPC-certified coders, CPB-certified billers, claims analysts, credentialing specialists, CMRS-certified reimbursement specialists, and others. Their concerted efforts have helped us deliver up to a 98% clean claims rate, reduce claims denial rates to less than 8%, and ensure timely reimbursements with days in AR of about 35-40 days. Additionally, we have achieved a nearly 95% net collection rate.
Benefits of Claims Submission Outsourcing
Claim submission for services rendered is essential for individuals and organizations to receive payment for goods and services. Here are some benefits of the services:
- Timely payment: Submitting claims for services rendered ensures that individuals or organizations receive payment for their goods and services on time, which is crucial for maintaining financial stability.
- Reduced administrative burden: Claim submission services can help reduce the administrative burden of processing claims, allowing individuals and organizations to focus on their core business operations.
- Improved cash flow: When claims are submitted and processed quickly, it can help improve cash flow by reducing the time between service delivery and payment.
- Accurate billing: Claim submission services help ensure accurate billing, reducing the risk of errors or omissions that could lead to payment delays or denials.
- Increased revenue: Submitting claims for services rendered can help increase revenue by ensuring all services are billed and paid for.
- Enhanced customer service: Claim submission companies promptly and accurately help improve customer satisfaction by ensuring customers receive timely billing information.
- Improved compliance: Claim submission services can help ensure compliance with regulations and requirements for billing and payment, reducing the risk of penalties or fines.
Trends in Claim Submission
Claim submission can vary based on industry and country, but here are some general trends:
- Electronic submission: With the increasing use of technology in healthcare, more claims are being submitted electronically. This trend is not limited to healthcare and can be seen across various industries.
- Automated claims processing: Claims processing is becoming increasingly automated, with many insurers using software to review and process claims quickly and accurately.
- Increased use of mobile apps: Many companies now offer mobile apps that allow users to submit claims quickly and easily from their smartphones or other mobile devices.
- Self-service portals: Some companies offer self-service portals where users can submit claims, track the status of their claims, and manage their accounts.
- Streamlined claims process: Many companies are streamlining their claims processes to reduce paperwork and make it easier for users to submit claims.
- Increased emphasis on data accuracy: As companies rely more on data to process claims, there is an increased emphasis on ensuring that data is accurate and up-to-date.
- Outsourcing claims processing: Some companies are outsourcing their claims processing to third-party providers specializing in this area, which can help reduce costs and improve efficiency.
What Our Customers Say
Invensis has been a great partner providing quality medical coding and billing services. The team is extremely responsive to every query we pose, and the turn-around time for deliverables is always as committed.
Invensis has been our revenue cycle management healthcare outsourcing partner for the past 5 years. They have always delivered on their commitments, whether it is meeting our Service Level Agreement (SLA) or improving our billing process.
We have been working with Invensis for the past two years, and they have helped us overcome many revenue cycle management challenges. The team often walks the extra mile to ensure that our needs are met.
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