Claim Submission Services in Medical Billing

The accurate and timely healthcare claims submission is essential for a healthy revenue cycle. A claim free of any errors and with complete information helps providers get paid faster. This leads to optimizing workflow, reducing administrative burden, and more time for patients.

Years of experience
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Clean Claim Rate
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Average Submission Time
0 - Hour
Reduction in Claim Denials
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What Is Claim Submission in Medical Billing?

Claim submission is the process of sending bills to insurance providers after a medical professional has provided the services. It's a way of requesting payment for the care the medical professional delivers.

The claims can be lodged either electronically or on paper. Electronic claims submission is faster, more secure, and preferred by most insurance companies. Paper claim submission, although still used in some cases, is slower to process and more prone to errors. The key types of claim forms include CMS-1500 and UB-04.

Claim Submission Process in Medical Billing

Our Detailed List of Claim Submission Services

Patient Registration

Insurance Verification

Coding & Billing

Claims Scrubbing

Claims Submission

Claims Follow-Up

Accounts Receivable Management

Payment Posting

HIPAA-Compliant & Secure Claim Submission

Your practice's data security and regulatory compliance are our top priorities. We maintain comprehensive HIPAA and HITECH compliance measures, incorporating bank-level security protocols that include 256-bit SSL encryption, multi-factor authentication, and 24/7 system monitoring.

Our team undergoes regular compliance training and background checks to ensure complete protection of patient health information. We conduct quarterly security audits and maintain robust disaster recovery plans to guarantee uninterrupted service and data protection.

Electronic Claims Submission
Submitting Claims

Top 4 Reasons Healthcare Providers Choose Us

  • Scalable Solutions

    Our billing services are very customizable. Whether you are expanding your services or adding more providers to your practice, we offer tailored support.

  • Lower Operational Costs

    With us, you don't need to spend money on staff training or software. We utilize the latest technology and employ professional staff without straining your budget.

  • Streamlined Workflows

    Our efficient claim process thoroughly reviews each medical claim. It reduces practice workload, and improves turnaround time throughout your claim cycle in medical billing.

  • Accuracy and Compliance

    Our professionals take enough time to file correct and prompt claims. This minimizes errors, denials, and compliance risks in your practice.

Our Claim Submission Process in Medical Billing

Start with Patient Verification

We gather and verify patient data, including health insurance details and eligibility, to ensure that all information is accurate and up-to-date.

Move to Charge Entry and Coding

Our certified coders use verified information for charge entry. They check CPT, ICD-10, and HCPCS codes for correctness and conformity with applicable requirements.

Generate and Scrub the Claim

A claim is created in the system. Before submission of claim, it undergoes a thorough scrub to catch and fix coding or formatting errors in the process.

Submitting Claim to Payers

Clean claims are submitted electronically to the appropriate primary or secondary payer for processing. Banner: Our electronic claim submission process ensures faster processing and reduced errors when working with insurance companies.

Track Claims in Real-Time

Each submitted claim is monitored in real time. This includes status updates to ensure that nothing gets stuck or lost in the system.

Handle Rejections and Resubmissions

If any claim is rejected or denied, we act promptly to identify the issue, correct the errors, and resubmit it for review.

Bonus: Get a customized report of your RCM performance in 1 click.

In-House Claim Submission vs. Our Services

Aspect
In-House Claim Submission
Our Claim Submission Services
Monthly Costs
$3,000-$8,000 per FTE billing staff
60-70% cost reduction with our services
Setup Investment
$15,000-$50,000 in software and training
Zero upfront investment required
Processing Time
5-10 business days average
24-48 hours guaranteed submission
Staff Management
Hiring, training, benefits, turnover issues
We handle everything
Technology Updates
Costly software upgrades and maintenance
Always current with latest technology
Compliance Risk
Higher liability for coding and billing errors
Reduced compliance risk with expert oversight
Revenue Cycle
45-60 days average collection time
30-40 days faster cash flow

Specialty-Specific Services

Our experienced team provides specialized claim submission services for:

dermatologically tested

Dermatology

stomach

Gastroenterology

hematology

Hematology

nephrology

Nephrology

neurology

Neurology

obstetrical

Obstetrics / Gynecology

ophthalmology

Ophthalmology

joint

Orthopedics

pain

Pain Management

microscope

Pathology

pediatrics

Pediatrics

physical therapy

Physical Therapy

surgery

Plastic Surgery

under

Podiatry

pulmonology

Pulmonology

mri

Radiology

oncology

Oncology

Certifications and Awards

Hear It Directly From Our Partners

Let's Make Your Claim Submission Process Faster and Error-Free.

Submission of Claims

Your Questions Answered

We'll need patient demographics, insurance details, encounter notes, and provider credentials. Our team guides you through a checklist to ensure nothing is missed.

A claim is typically submitted within 24 to 48 hours, depending on the readiness of documentation and the availability of the provider.

We have a specialized rejection management staff that swiftly examines, corrects, and resubmits claims to guarantee speedy resolution. This helps maximize your collections with minimal effort from your side.

Yes. We adhere to strict HIPAA regulations and utilize encrypted, secure platforms to ensure comprehensive data protection.

Not necessarily. We integrate with most leading systems and work with your existing setup to streamline claims, minimizing disruptions to your workflow.

Need Help Manage Your
Practice Needs?

Complete the form, and our expert team will reach out to understand your unique needs and provide tailored solutions to drive your practice’s success.

Let’s discuss together.

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