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3 Technologies Changing, “The Medical Billing Insurance Claim Process”



A healthcare provider face a few certain difficulties to get the patients insurance claim passed. From verification of eligibility, checking the right coding and to checking the accuracy of Invoice, all the steps mentioned above are very tedious. Indeed, even after this, at some points healthcare provider need to hold up more than three months to get a claim paid.

There are several possibilities where the claim can get stuck and can take longer to be sorted out. The common errors of failure in capturing right information about patient, implementing the inaccurate coding and manual claim process often create trouble for insurance provider to release the right amount of the  claim.

Besides these challenges there is one more progressive and unseen challenge for healthcare providers is that on a few occasions they struggle to secure reimbursement from patients too. Every year a health care provider bears the huge amount in face of bad debts. The numbers of uncollected invoices are increasing every year.

Gradually it was collectively felt by healthcare providers that they are not able to handle all these non-core activities as they were losing focus on their core business and additionally they sliding down towards the bottom line. Hence they strongly felt the aide from someone who has the expertise in the process of medical insurance claims procedure.

Fortunately, there are a few most recent technologies are accessible to rescue healthcare providers from getting their medical billing claims paid without any noticeable delay, few of those technologies are referenced hereunder:

The CDI (Clinical Documentation Improvement) Program

The top most reasons for a claim denial are identifying with documentation errors. If these errors can be brought down to a diminished level, there would be more chances of claim to be accepted right away. The CDI Program guarantees convenient, accurate and timely imbursement in this regard. During last few years CDI Programs has gained a good amount of popularity because of its simplicity and versatile effects on medical insurance claims process.


The unbeatable platform of Blockchain

In this platform a patient’s records are gathered accurately including the history of procedures in a way that claim can reduce and prevent the losses. Blockchain platform is not only used by healthcare providers but it is also used by payers to manage the electronic data as well as trials data as per statutory compliance. Both parties can share the data in most easiest and secure way through this platform. The best feature of Blockchain is that it can reconcile all transaction in real time. Additionally, it speeds up medical insurance claims process.

CACS (Computer Assisted Coding System) Application

CACS represents a Computer assisted coding system, that is a software that dissects medicinal documents and records to creates suitable medical codes for precise phrases and terms in that particular document.

All of the above-mentioned technologies are readily available in the market for providers as well as payers; these technologies ensure optimization of their medical billing insurance claim procedures and simultaneously boosts the chances of enhanced reimbursements. There are several experienced outsourcing companies available in the market to which if you make your outsourcing partner, you will soon see the increased bottom line of your organization in no time.

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