Submitting
a claim to an insurance carrier can
be as complicated or as simple as
you want it to be. Today there are
several options for submitting claims.
You can submit directly, or go through
a clearinghouse; you can use Medicare
THIN or even use a free service such
as FreeClaims.com.
Here is an analysis of the various
methods of submitting a claim, as
well as a comparison between them.
Submitting a
paper claim
Using the paper form to submit a claim
means actually printing it, folding
it, stuffing it, stamping it and mailing
it. However, this method is virtually
extinct, since you will not be paid
sooner than 4-6 weeks, and it is an
expensive process to mail out so many
letters.
Moreover, if there are any errors in your claim, it will be returned
to you and you will have to resubmit; all of these paper
exchanges can span months, during which you are simply
waiting to be paid.
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Submitting
a claim directly
The main incentive to use this method
is the cost: submitting a claim directly
costs you nothing. In addition, you
can get a response in 7-14 days. However,
there are some negative factors that
outweigh the lack of cost. Most importantly,
the report that you receive back from
the insurance carrier is very difficult
to read. Often you need someone to
decipher it for you.
There are other issues as well: you
need a dedicated phone line for this
purpose and you need hyperterminal
setup to submit claims directly. Also,
you must send the claims in EDI, which
is virtually non-readable WHAT??
Once you have submitted the claim,
you will not know if there are any
errors until it is sent back to you.
You must then correct the errors and
resubmit the claim. This can slow
down your payment considerably.
Submitting via a clearinghouse
To speed up the process a bit and avoid the occurrence of
errors, many people submit claims via a clearinghouse. The
clearinghouse option is very user-friendly; you must upload
the file to the clearinghouse and wait one day, during which
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