From Care to Compensation, Part 2 -- From Claim to Billing
Claims get lost occasionally in the electronic transfer process, when leaving the billing system or entering the payer's processing system. Tight controls must be in place to track the electronic submission of batches of claims, to know when they arrived in the payer's system, the total number of claims accepted, and the dollar amount of each claim batch.
It is common for electronic clearinghouse or payer systems to attempt to process a batch of claims, get part of the way to completion, and then fail to finish. Lost claims will obviously not get paid until someone notices that they are lost and fixes the problem.
Lost Claims
Claims get lost occasionally in the electronic transfer process, when leaving the billing system or entering the payer's processing system. Tight controls must be in place to track the electronic submission of batches of claims, to know when they arrived in the payer's system, the total number of claims accepted, and the dollar amount of each claim batch.
It is common for electronic clearinghouse or payer systems to attempt to process a batch of claims, get part of the way to completion, and then fail to finish. Lost claims will obviously not get paid until someone notices that they are lost and fixes the problem.
SHARE
