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Reimbursement
Assistance
Claim forms are submitted to the insurer/payer by the provider
of service. Claims identify patient demographic data, code assignments,
services provided and the charges associated with those services.
The following helpful tips ensure the accuracy of submitted claims
and reduce the possibility of delayed or denied claims.
- Insurance benefits vary from plan to plan. Be sure to verify
each patient's benefits.
- Ensure insurance information is updated to accurately complete
claim forms.
- File claims promptly after the service has been rendered.
- Make sure all coding information is accurate (i.e., code numbers
are not transposed, correct vial units are depicted, diagnosis
and procedure codes are linked, etc.)
- Collect patient copayments and coinsurance at the time service
is rendered.
- Conduct follow-up with insurers to ensure timely claims processing.
- Be prepared to substantiate medical necessity to comply with
insurer requests for utilization of services.
- Monitor and identify reasons for denied claims.
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