Insurance Billing Process
Following are the key steps in processing and billing claims:
- Find claims that have not been billed or that require attention.
The status of such claims is On Hold, Timed Out, Underpaid, Overpaid, or Rejected. See Searching for Claims.
- Review and, if necessary, edit claims. See Reviewing and Editing Claims.
- Preview CMS 1500 forms if necessary. See Previewing CMS 1500 Forms.
- Set the status of claims to Ready to Bill. See Setting Claim Status to Ready to Bill.
- Bill claims to insurance carriers by using one of the following methods:
- Bill individual claims manually. See Manually Sending Individual Claims to Carriers.
- Bill claims manually in batches. See Manually Sending Claims to Carriers in Batches.
- Bill safety claims. See Billing Safety Claims.
- Bill claims through TriZetto. See Billing Claims through TriZetto.
- If an insurance carrier rejects a claim, perform one of the following actions:
- Review and resend the claim to the insurance carrier.
- Bill the claim to the patient. See Billing Patients.
- Write off the claim. See Writing Off Claims.