The Reality of Claim Submission
Electronic claim submission and billing have been on the rise for many years. Most insurance companies will not even accept paper claims anymore. It is clear that making the switch to digital has many benefits.
While it may seem like the process has moved online, medical office workers still report that most prior authorization is done by fax or over the phone. These ways of the past are certainly not the most efficient way to complete the claim and billing process.
There are many factors that go into having the most efficient electronic claim submissions and it all starts with effective practice management software. When you have a way to gather patient insurance information before they even step in the door, the whole patient workflow process becomes much easier from start to finish.
While most can agree that the claim submission process runs smoother online, there are still some ways of submitting claims electronically that outshine the rest. Specifically, using an all-in-one system will save your office a significant amount of time and money. These systems can use already submitted patient information to start the pre-authorization process without the need for your office staff to lift a finger.
So let’s take a look at all of the ways electronic claim submission can save your practice time and money.
Time Saver for Staff and Patients
Admit it, the process of submitting and managing insurance claims is tedious at best and terrible at worst. This process eats up the time of office staff and can delay patients getting the care and prescriptions that they need. On average, practices complete 41 prior authorization requests per physician, per week.
In a study done by The American Medical Association, they found that processing these requests takes about 13 hours per week. That is the equivalent of almost two full business days lost to just the prior authorization portion of submitting and billing claims. With how much your practice has going on already, you can’t afford to lose two whole days a week to this pre-authorization process.
The burden of this pre-authorization process takes a significant toll on physicians and front office workers. Not to mention the effect waiting for treatment has on patient satisfaction. There is nothing worse for a patient in pain than having their treatment or prescription delayed due to unknowns regarding their insurance.
Faster claims submission also means faster pay. Electronic claims are submitted instantaneously to a payer. It takes about a third of the time to get reimbursed for a digital claim compared to a mailed claim. Instead of waiting and wondering if your claim got lost in the mail, with electronic claim submission you can see updates every step of the way. You will know the status of your claim at all times.
When you have a practice management system that can generate claims with just one click from patient notes, the time saved is considerable. This level of efficiency is also better for your patients because you can give them answers about their coverage and copay immediately. Patient satisfaction will increase tenfold when they realize they no longer have to spend hours waiting to see if the care or prescription they need is covered. The time saved for all parties involved makes switching to electronic claim submission a no-brainer.
Cut Costs and Save Money
Electronic claim submission can save your practice money in many different ways. The American Medical Association and the Connecticut State Medical Society found that a physician practice that manually performs claims transactions spends $70,000 a year compared to $28,000 for a practice that uses electronic claim submission. This means your practice could save over $40,000 a year just by submitting claims electronically.
Doing things electronically also leads to fewer errors and typos. This means fewer rejections and increased cash flow. A study by Advisory Board found that “90% of claim denials are preventable.” One of the main ways to prevent claim denials is to limit errors in submissions. Electronic claim submission has helped this problem and is proven to dramatically reduce the number of rejections a practice receives.
If your submission for prior authorization has an incorrect ICD-10 or CPT code, this can lead to additional costs for your practice or the patient. If a patient receives treatment for something not listed on their plan, they will likely receive the bill. If your errors lead to a patient having to pay an unexpected bill, they will at best be irritated and at worst find a new physical therapist.
On the other hand, when your office doesn’t receive the correct pre-authorization for a service, it can lead to costs for the practice. Billing the patient in this scenario is not good customer service, so most offices end up writing off the cost.
However, mistakes are bound to happen. That is why it is crucial to have the right software system that will catch these mistakes for you. Certain electronic claim submission software systems pre-audit claim fields for potential errors automatically. With integrated software systems like PatientStudio, not only is the billing process easier but errors are caught much earlier on so that no money is lost.
How to Choose the Best Electronic Claim Submission System for Your Practice
Electronic claim submission can be confusing. Depending on the system you choose, it could cause more frustration for your staff. That is why it is so important to choose an electronic claim submission program that is both efficient and easy to use.
An all-in-one software system is the only option that offers a completely streamlined process. Imagine a scenario where a patient note is made for a patient whose shoulder is hurting. With an integrated system, the preauthorization process will automatically start as soon as the physical therapist documents the condition.
A unified system means all information needed for authorization for claim submission is already on the same platform. With this type of system, you will never have to waste time re-entering data for your claim submissions.
So while the world of electronic claim submission is growing, there is only one type of system that fully maximizes time and money savings. The best billing solution for your practice is synced with a completely integrated practice management software.
To schedule a demo of the electronic claim submission and all features offered by PatientStudio follow the link