What is claim submission?
Claim submission is the process of sending a claim for payment to an insurance company or other payer for healthcare services provided to a patient. The claim includes information about the patient, the healthcare provider, the services provided, and the charges associated with those services.
Submitting claims is an important step in the healthcare revenue cycle management process, as it is the means by which healthcare providers receive payment for the services they provide. Claims can be submitted electronically or on paper, depending on the preference of the payer and the capabilities of the healthcare provider.
When submitting claims, healthcare providers must ensure that the information on the claim is accurate and complete, including patient demographic information, provider information, diagnosis codes, procedure codes, and charges. The claim must also comply with the specific requirements of the payer, such as submitting claims within a certain timeframe and using specific billing codes.
Once the claim is submitted, it is processed by the payer, who reviews the claim for accuracy and completeness, and determines the amount of payment due to the healthcare provider. The payer may also request additional information or documentation to support the claim.
How incorrect claim submission can impact the revenue cycle cashflow?
Incorrect claim submission can have a significant impact on the revenue cycle cash flow of healthcare providers. Here are some ways in which incorrect claim submission can affect the revenue cycle cash flow:
Delayed payments: If a claim is submitted with errors or incomplete information, the payer may reject the claim or ask for additional information, which can delay payment. This can cause cash flow problems for healthcare providers who are waiting for payment to cover their expenses.
Denied claims: If a claim is submitted with errors or does not meet the specific requirements of the payer, the claim may be denied, which means that the healthcare provider will not receive payment for the services provided. This can result in a significant loss of revenue and a negative impact on cash flow.
Increased administrative costs: If a claim is submitted with errors, the healthcare provider may have to spend additional time and resources correcting the claim or appealing a denied claim. This can result in increased administrative costs and a reduction in profitability.
Negative impact on reputation: Incorrect claim submission can result in poor relationships with payers, which can damage the reputation of the healthcare provider. This can result in a loss of business and a negative impact on cash flow.
In short, incorrect claim submission can have a significant impact on the revenue cycle cash flow of healthcare providers. By ensuring that claims are submitted accurately and with complete information, healthcare providers can improve their revenue cycle performance and maintain a positive cash flow.
How outsourcing claim submission services to OneMed can help healthcare organizations?
Outsourcing claim submission services to OneMed can provide several benefits to healthcare organizations, including:
• Expertise and experience: OneMed has a team of experienced and skilled professionals who specialize in revenue cycle management and claim submission services. They are well-versed in the latest industry regulations and guidelines, and can ensure that claims are submitted accurately and in a timely manner.
• Increased efficiency: OneMed uses advanced technology and automated systems to streamline the claim submission process. This can help to reduce errors, minimize the risk of rejected or denied claims, and improve overall efficiency in the revenue cycle management process.
• Improved cash flow: By ensuring that claims are submitted accurately and in a timely manner, OneMed can help healthcare organizations to improve their revenue cycle performance and increase cash flow.
• Reduced administrative burden: Outsourcing claim submission services to OneMed can help to reduce the administrative burden on healthcare organizations, allowing them to focus on patient care and other important tasks.
• Customized solutions: OneMed can provide customized solutions to meet the unique needs and requirements of each healthcare organization. This includes tailored workflows, reporting, and analytics that can help healthcare organizations to optimize their revenue cycle management processes.
Overall, outsourcing claim submission services to OneMed can help healthcare organizations to improve their revenue cycle performance, increase cash flow, and reduce administrative burden, allowing them to focus on delivering high-quality patient care.