Claims Processing

When it comes to medical billing, processing and releasing claims is one of the most important pieces of the process.

How to process a claim

In this section, a Certified Revenue Cycle Consultant guides you through the process of processing a claim. We don’t just talk you through the process – we walk you through the process! We’ll talk about ways of setting your business apart leading to increased cash-flow for your potential clients as well. This section is one you’ll refer back to time and time again.

Maximize reimbursements with modifiers

Processing a claim isn’t always as simple as pressing a button. In the medical billing and revenue cycle industry, the charge codes you submit (CPT codes) often times require a modifier. Utilizing modifiers properly can increase or maximize your clients revenue leading to maximum income for your billing business. Using modifiers improperly can cost you thousands. We’ll go over the basics, and then we’ll discuss ways to ensure you ensure your clients never miss out on another opportunity to properly use a modifier again!

Maximize reimbursements with modifiers

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How long should a claim take?

Once you submit a claim, the claim filing process may not be done. In this section, we’ll cover what you need to do to ensure your claims are “on-track” to get paid. Depending on the insurance company, you may be able to get your clients paid in as little as just a few business days! In some cases, depending on the insurance company it could take far longer, upwards of 30 business days. It’s important to understand the average processing time – this section is sure to provide knowledge that will carry you for years to come!

Claim denials: Most common reasons

Member benefit issues, coding related issues, bundling issues, place of service issues all resulting in a denial! Our goal over the course of this lesson is to walk you through each of these denial reasons (and more). Taking each one individually and training you to understand the potential reasoning behind the issue, how to resolve it, and when to get your client involved! Getting your clients paid faster!

Claim denials: Most common reasons

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CLAIMS PROCESSING is included
in THE BASICS COURSE

The Basics Course has everything you need to start your billing business today.

Also included in The Basics Course:

  • Medical Billing 101
  • Medical Billing Software
  • EMR/EHR Software
  • Typical Day-to-Day
  • Contracts 101
  • HIPAA Compliance 1.0
  • Accounts Receivable
  • Marketing