Charge Entry & Claims Management

We utilize advanced technology and software to streamline this process and minimize errors, resulting in faster reimbursements for healthcare providers.
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MEDICAL BILLING & REVENUE CYCLE MANAGEMENT

Charge Entry & Claims Management

Filing claims and collecting payments from commercial and government payers is the financial lifeblood of healthcare organizations. Powered by insights drawn from TriumpHealth’s network of physicians we streamline your claims management workflow for faster and more accurate medical claims processing, lower costs, and higher efficiency.

Our claims management team regularly monitors the status of your claims. Based on payer data, we calculate the average remit times and send claim status inquiries accordingly. With our unique billing rules database specific to each payer, that is continuously updated based on our experience working with physicians from different specialties, our first-pass clean claim rate is higher than 90%, and therefore you get paid more and faster.

Frequently Asked Questions

What is charge entry in healthcare, and how does it play a crucial role in the revenue cycle?

Charge entry in healthcare involves the accurate recording and input of medical services or procedures into the billing system. It plays a crucial role in the revenue cycle by ensuring that all billable services are properly documented and billed to insurance companies or patients, ultimately impacting the financial health of the healthcare organization.

How do you ensure accurate charge entry, and what steps are taken to minimize errors or discrepancies in the billing process?

Ensuring accurate charge entry requires comprehensive training for billing staff, double-checking entries for accuracy, implementing automated systems for charge capture, and conducting regular audits to identify and correct errors. Steps taken to minimize errors include maintaining updated fee schedules, verifying insurance coverage, and adhering to coding guidelines.

Can you explain the significance of claims management in the context of healthcare billing and reimbursement?

Claims management in healthcare billing involves the process of submitting, tracking, and managing claims to ensure timely reimbursement for services provided. It is significant because efficient claims management directly impacts cash flow, revenue generation, and overall financial performance of the healthcare organization.

What strategies do you employ to optimize claims management and expedite the processing of medical claims?

Strategies to optimize claims management and expedite processing include implementing electronic claim submission, leveraging claim scrubbing software to identify errors before submission, monitoring claim status regularly, and maintaining open communication with payers to address any issues promptly.

How do you handle denials and rejections in claims management, and what measures are taken to resolve these issues promptly?

Handling denials and rejections in claims management requires identifying the root causes of denials, appealing unjustified denials, and implementing corrective actions to prevent future denials. Measures taken to resolve these issues promptly include analyzing denial trends, providing additional documentation or information as needed, and following up with payers to ensure timely resolution and reimbursement.

Our Process

1

Data Collection and Verification

Gather patient encounter information and verify accuracy, including demographics, insurance details, and procedures performed.

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2

Coding and Charge Capture

Assign appropriate medical codes to services rendered during patient encounters, ensuring compliance with coding guidelines and payer requirements.

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3

Charge Entry

Enter coded information into the billing system, including charges for procedures, treatments, and services provided to patients.

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4

Quality Assurance and Review

Conduct thorough reviews of entered charges to minimize errors, verify coding accuracy, and ensure completeness before submitting claims for reimbursement.

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Benefits of Working with TriumpHealth

Charge Entry & Claims Management

Timely Claims Filing

Editing claims online with real-time data validation makes for fast turn-around of claims that you would otherwise need to re-bill from scratch.

Lower Claim Costs

By using payer specific claim editing and validation tools we reduce the turn-around-time for claim submission.

Reduce Waste of Time and Money

Our automated claims monitoring process reduces the time invested in manually checking claim status.

Managing Rejections & Denials Faster

Our visual interface shows potential claim issues quickly, helping us reduce the investment in follow-up time.

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We will help you achieve financial and regulatory compliance goals resulting in improved patient outcomes and increased revenue.