Electronic Claim Submission vs. Paper Claim Submission
Even though most medical insurance carriers are now mandating that medical claims be submitted electronically, 40% of all healthcare providers still send paper claims through the mail. Some medical insurance companies charge a fee for paper claim submission yet close to HALF of all healthcare providers still submit their claims this way.
Roughly translated, healthcare providers are spending $7 to $12 per claim along with more than $700 million per year on postage. The bottom line is that healthcare providers spend over $7 billion per year submitting paper claims. There's more.
Paper claims take 15 to 20 minutes to prepare and are subject to a 30% to 35% rejection rate due to submission errors, typos and omissions. Reimbursement will take an average of 90 to 120 days, but that's only for claims without errors. Claims with errors are sent back to the provider for correction, taking yet another 90 to 120 days for payment. In addition, paper claims have no "proof of filing." This means that medical insurance companies won't hesitate to tell the provider "we never received the claim."
Electronic claims, on the other hand, cost healthcare providers $1.50 to $3.00 per claim and take only several minutes to prepare. The rejection rate for electronic claims is a mere 1% and reimbursement is made within 7 to 21 days. Errors with electronic claims are immediately detected by the clearinghouse (the go between or middle man between the insurance company and the healthcare provider). Clean cleans are processed usually within 24 hours by the insurance company who either accept or reject the claim. Additionally, the claim is "time and date stamped" so that medical insurance companies can't say they never received the claim.
Any debate between electronic claim submission and paper claim submission is virtually non-existent. Electronic claims submission is faster, cheaper and far more effective. Hands down. So, why in the world would healthcare providers continue to submit paper claims?
Simple. Fear and a lack of knowledge.
Most healthcare providers haven't a clue as to how the internet works so they're reluctant to use this technology. Medical management companies have preyed upon these fears, intimidating providers to such a degree that most will purchase overpriced software packages with costly updates, expensive clearinghouse services and high-priced communications systems, and much, much more. These companies have also offered to do the billing for these providers, but at a very high price.
The answer?
Eliminate the fear of submitting your claims electronically by learning all you need to know. For now, this is what you'll need:
- good, reasonably priced medical billing software
- a reasonably priced clearinghouse
- your everyday, run-of-the-mill DSL service
After we too were swindled out of thousands upon tens of thousands of dollars for multiple medical management software packages and billing franchises, we found that ONLY ONE billing system will do EXACTLY what it is has been designed to do. Click here to find out more
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