What is reimbursement in health insurance?
Healthcare reimbursement is the amount that the healthcare center receives for a particular service they have provided to their patient. In the healthcare industry, the payers and insurers cover the patients’ bill payments according to the terms they have signed up for a while taking the insurance. If you do not have insurance coverage, you will be responsible for paying the entire bill.
Since it is the healthcare provider’s payment after treatment, it is called healthcare reimbursement.
Several steps take place in the process of Healthcare reimbursement. Knowing the processes and understanding their importance will bring clarity to you so that you will be able to fasten the process of reimbursement.
What is the reimbursement process?
Entering Patient Data
Patient data is available easily, thanks to the electronic health record (EHR) in today’s world. The electronic health record database has helped significantly capture and organize the data on a daily basis. Hence ensuring the entry of correct data is of utmost importance. If this step is monitored right, it will save you the trouble of claim denials and claim rejections.
I-Conic Solutions helps you automate the data collection to make the process smoother and more efficient. It will avoid primary errors, which will reduce the risk of claim denials and rejections. In addition, it will be one step to enhance your revenue cycle management.
Medical Coding
The insurers pay reimbursements according to the medical codes mentioned in the records. These codes are the standardized codes that include the International Classification of Diseases (ICD-10) and Current Procedural Terminology (CPT) codes.
Every individual code signifies a certain service. Therefore, it is essential that you have trained professionals handling the code because your reimbursements depend on them.
I-Conic Solutions gives proper assistance to help you out with the medical coding. Each member of the Medical coding team is a certified professional to improve your revenue cycle management system.
Claim Submission
When it concerns healthcare reimbursement, claim submission is important to process. Hence, we have automated the process and minimized the error percentage to avoid unwanted circumstances of claim rejections or denials. It will optimize the entire revenue cycle of your healthcare organization.
We look after the entire process of claim submission. Beginning from the claim submission to the follow up to get you the complete amount of healthcare reimbursement.
Dealing with Payment Rejections
There could be several reasons for a claim rejection, such as:
- Misfiled claim codes
- Improper service offerings
- Lack of patient coverage
- Incomplete medical data
To manage this situation, re-submitting and escalating claims may seem time-consuming. First, however, you have to keep the data back on your end. At I-Conic Solutions, we give you an effortless experience when it comes to dealing with claim rejections while building an optimal revenue cycle for your organization.
