Claims Submission
Industry experience shows that a large percentage of medical claims are rejected for various reasons. Thus, an efficient process of medical claims submission is important for healthcare service providers. This process has to be systematic and the people involved in claims submission (front and back office) need to understand the administrative procedures.
No two practices operate the same - and this is why we are different. We know that it is necessary to understand your specific practice and then apply our expertise to customize the processes and maximize the value to your business.
CAPRN medical claims submission services
At CAPRN we use an effective medical claims processing software that minimizes the turnaround time while increasing the accuracy and security of sensitive patient data. We have developed a proprietary tool to audit claims before we send them to the clearinghouse. This tool filters out common human errors such as a missing modifier or a missing authorization. It helps us to ensure that diagnosis codes and charges are entered properly thereby increasing the clean claims percentage. Here are some specific features of our service:
- CAPRN receives the imaged superbills and patient schedule.
- CAPRN verifies insurance information and updates with any relevant changes.
- As required, CAPRN performs data entry of patient demographics, referring physician, CPT and ICD Codes, and Modifiers.
- CAPRN performs a controls review to verify patients on the schedule, charges, and payments received.
- CAPRN runs our audit tool, reviews findings and makes changes if any coding errors are discovered.
- CAPRN transmits the claims.
- CAPRN monitors the claims logs for rejections and denials.
- As required, CAPRN images the incomplete or missing documents and requests clarification on them.
- CAPRN provides periodical reports on claims status as well as work-in-progress.