Claim Filing & Processing

At ECBC we recognize and value the importance of accurate and timely healthcare claim filing & processing. The medical claims and billing specialist assigned to your account will very carefully and meticulously examine all pending charges or superbills for accuracy and completion.

→ Overview of Claim Filing & Processing

Current procedural terminology (CPT), HCPCS codes, ICD-10 diagnosis codes – with their associated pointers, and modifiers as well as any active corresponding LCDs and/or NCDs are closely reviewed and compared against prior billing history (as to avoid bundling edits for those patients in an active global period) while our talented specialists concurrently review against the latest coding logic and smart edits available.  

→ Coding Verification

We routinely examine every claim to verify that coding not only meets established payer guidelines, but that our providers are credited for every service rendered to their patients.  This is made possible via thorough review of the patient’s electronic medical record. Providers are made aware of any inconsistencies found in the record and are presented with an opportunity to make corrections, if applicable.  These important steps allow us to make the most of every claim while in turn, maximizing collection rates.  

→ Data Verification

Demographic and insurance data is also reviewed for data entry precision.  We work closely with our provider offices to streamline the patient registration process and to share the most accurate and up-to-date information regarding known policies for most of the major insurance carriers.

→ Staff Training for Effective Claim Filing

We go the extra mile when needed, provide training of front-desk personnel, and assist with analysis of patient eligibility data so that our provider offices are well-equipped and prepared to handle patient flow.  When claim filing, we believe a clean claim begins with ensuring that office support staff is set up to acquire accurate patient data.  Providing the needed support in this important area is standard practice at ECBC.  After a thorough review of all insurance claims marked for submission, claims are then filed either electronically through the applicable clearinghouse, via paper claim submission or through their respective portals.

→ Claims Monitoring

We work with an array of clearinghouse companies and have experience with EDI enrollment registrations for any providers submitting to new payers or to a new clearinghouse for the first time. Once claim filing has begun, we monitor and track the claims to ensure acceptance and proper forwarding to payers.  Errors, if any, are resolved and turned around immediately, reducing the number of AR days.

→ Claims Filing from ECBC

While there are many claim filing & processing companies available to choose from, our attention to detail and close partnerships with our clients are what we truly believe sets us apart.