Thursday, September 18, 2008

When to send attachments with claims?

Are you still mailing paper claims to insurance carriers because you feel you need to attach supporting documentation for the processing of your insurance claim? Well, as more and more information is getting transmitted electronically it maybe possible to stop sending things by paper or at least eliminate the need for the majority of your claims.

Aetna Health Insurance has just released an announcement encouraging all medical offices to send all claims electronically including primary and secondary insurance claims. If for any reason they need supporting documentation they will notify you by EDI reports or through a EOB asking for this information.

Aetna Health Insurance for example is noticing they are still receiving a high volume of paper claims with attached paperwork. Anytime a claim comes through with attached paperwork it slows down the processing of your claim because they need to "touch" the claim by a human. This means your doctor will receive insurance payments later than normal from Aetna on these claims which hurts your office. They ask that in order to minimize the slowness of insurance payments to send everything electronically.

  • Aetna Insurance rarely needs progress notes
  • Aetna Health Insurance does not require paper copies of referrals. They have a computer system that tracks data from the referral system. If their is a match, the claim is quickly processed.
  • If Medicare was the primary carrier and MA18 appears on a Medicare explanation of payment you do not need to mail in a secondary claim

If the claim does require any additional information they will notify you through EDI reports and EOB's.

In short if you are still sending high volumes of claims by paper contact those insurance carriers and identify if and how you can send them electronically to save time and money.

For those clients that bill using RelayHealth you will use CPID# 4500 and 6400 to bill to Aetna Health Insurance. Aetna Insurance accepts claims electronically as a primary and secondary.

Learn more about Electronic Medical Billing and Coding at this site medical billings and health insurance claims

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