For Claim creation the process starts with Demographics
entry and insurance verification. Either through scanning documents to our billing
team or having it shipped in packages we collect all the information necessary to
generate an encounter: demographics, insurance information, and icd/cpt codes.
Once the information is retrieved the claim
can be created using two methods:
Manual Claim entry: Claims are created directly into
the PM system from a route slip or superbill. Before any claim is generated verification
is done for patient's insurance eligibility. At the time of icd/cpt entry various
online tools will be used to insure correct coding is done with modifiers, units,
Autogeneration: Claims are automatically created directly
from the appointment scheduler. ICD/CPT codes, modifiers, and units are entered
into individual patient appointments along with Demographic information and patient
insurance details. If any copayments are posted into the appointment details they
are directly transferred into the encounter. At the end of the autogeneration process
auditing of the newly created claims can still be done before submission.
* Price are based on offshore working team member.