Insurance Billing Routines, Posting Payments and Secondary Insurance Billing

Insurance Billing Routines, Posting Payments and Secondary Insurance Billing

Name the three steps involved in the claims management process.

The three Steps involved in the claims management process include ,preparing an effective plan for reporting injury suffered. A prompt editing and submission of claim to concerned authority like IWIF (Injured Workers Insurance Fund). An active involvement and follow up of the process.

Provide examples where paper claims might be necessary over electronic claims submissions.

Paper claims might be necessary over electronic claim submissions, when additional documentation like report of operations or supporting evidence is required by the Insurance Company. Sometimes various health plans also need paper based claims as a part of their form. Some disclaimers like waivers for surgical procedures also need paper documentation. They can also be needed when EOB from main insurance is needed along with the claim by a secondary insurance billing system. Also usually a medical bill is prepared on paper and mailed to the insurance carrier, claims administrator, or other party indicated by the patient to be the source of his medical insurance coverage.

There are a number of items insurance companies require in order to process medical billing claims.

Number of items that are required by insurance companies in order to process medical billing claim include: Social Security Number, Information about the health plan along with the Plan number, Policy number, Nature of extent of coverage provided by the plan, Date at which the plan is valid from and till, Name and the social security number for each person entitled to benefit from the policy, Class under which each benefice is entitled , mailing address, Details and mailing information of care provider, services rendered accompanied by the location where they were provided, Code for diagnosis, Date of service rendered , Signature ...