Here are the top 5 points for submitting a claim to insurance companies:
1. Documentation: Accurately document the medical services provided during the patient encounter, including procedures performed and diagnosis codes.
2. Claim Creation: Create a claim by assigning appropriate medical codes (CPT, HCPCS, ICD-10) to the documented services.
3. Completion of Claim Form: Fill out the claim form with patient demographic information, insurance policy details, and the billed amount.
4. Submission: Submit the completed claim electronically through a clearinghouse or directly to the insurance company via an online portal or by mail.
5. Adjudication: The insurance company processes the claim, verifying coverage, reviewing billed services, and determining the amount payable based on the patient’s benefits and provider’s contract.
