Electronic Claim

Electronic Claim Submission

Medicorex is a healthcare technology company that provides Electronic Claim Submission (ECS) software to healthcare providers. The software allows providers to submit claims for reimbursement to insurance companies electronically, reducing the need for paper claims and increasing the efficiency of the reimbursement process. ECS software can also help providers to ensure that their claims are accurate and complete, reducing the likelihood of denied or delayed claims. Medicorex’s ECS software also provides features such as real-time claim status updates and support for multiple payers, which can help providers to manage their billing process more effectively.

Electronic Claim Submission is the process of submitting claims for payment or reimbursement to insurance companies or government programs electronically, rather than by paper. This service typically includes the following steps
  1. Gathering and verifying patient information
  2. Entering data into the electronic system
  3. Formatting the claim according to the required standards
  4. Submitting the claim to the payer for processing
  5. Tracking the status of the claim and any necessary follow-up
  6. Retrieving and interpreting the payer’s response
  7. Resubmitting the claim if necessary

Benefits of submitting claims electronically

Electronic Claim

Printing and completing manual forms is a painstaking process that just can’t be automated. Your medical billing service can compile electronic claims in a fraction of the time through automation processes that minimize errors. It can then submit these error-free claims almost immediately.

Resource savings

Creating and submitting manual medical claims requires lots of front-office staff time, not to mention a budget for postage. Neither of these conditions applies to electronic claims. In fact, the research found that switching from manual to electronic billing can lead to annual cost savings as high as 60%

Claim scrubbing

Even the most experienced medical billers and coders are bound to miss errors when double-checking claims. After all, they are human. Computers and machines are much more accurate. Claim scrubbers, which are fully automated, rapidly catch claim errors and flag them for correction before payer submission.

Integrated clearinghouses

Sending claims via mail introduces all kinds of potential delivery errors. Your claims could get lost, or you could send them to the wrong address. The integrated clearinghouses that drive the online medical billing process instead direct your claims exactly where they should go in just seconds. As a result, you can submit your claims to payers almost immediately.

Claim scrubbing

If you send claims by postal mail, you won’t know they’ve reached the insurer unless you pay extra for tracking. Even if you do pay for tracking, you won’t know your claim’s status after delivery until the payer sends you an acceptance, rejection or denial in the mail. With electronic claims, you can instead see your claims’ real-time status every step of the way through a detailed audit trail.

Faster payer reimbursement

Postal mail can take several days to reach its destination. If you’re sending a claim or awaiting reimbursements via postal mail, the process can add unnecessary delays to the billing cycle. Conversely, electronic claims go through instantly, and payers can reimburse you the moment they approve your claims. Any billing cycle delays will be eliminated.