The first six months of fiscal year 2009 saw dramatic improvements in customer service scores, along with improvements in both cash levels and clean claim
If the claim is submitted electronically, it "must us[e] the applicable format that complies with all federal laws related to electronic health care claims, including applicable implementation guides, companion guides and trading partner agreements" to constitute a clean claim
A clean claim
, according to Congress, is one "that has no defect or impropriety .
When the encounter information is submitted the system performs insurance eligibility, codes the performed services according to the receiving payer's rules, checks charges against the appropriate fee schedule and electronically submits a clean claim
to the payer.
Definitions of terms such as clean claim
, insurer, provider, etc.
a) A licensed insurer or a managed care plan shall pay a clean claim
submitted by a health care provider within forty-five (45) days of receipt of the clean claim
Generally speaking, all the laws require insurers to pay providers within a specified period of time--usually from 15 to 45 days--for any clean claim
Generally speaking, insurers must pay providers within a specified time period--usually 15 to 45 days--for any clean claim
In today's marketplace, you must be sure that all claims are clean and that no clean claim
is denied--not a single legitimate one
maximizing appropriate payments - charge capture, clean claim
submission and denial management.
1052) contain language that would amend ERISA and other statutes to require that health insurers and Medicare Plus Choice organizations make payments within 30 days of a clean claim
EVA gives providers the ability to review their claims and receive feedback on claim errors before submitting, helping to send a clean claim
to the payer the first time.