Earlier this week, a prospective client [an ENT consultant] called MHM and advised he had been forced to stop producing paper invoices. In future he was required to submit all claims to insurance companies electronically. Thus he wished to know two things – why should he and what was in it for him?
Why should he?
Effectively he should because some insurance companies have stopped accepting paper invoices. They have dictated submission of claims is required electronically. The requirement is part and parcel of their recognition protocols. It is only a matter of time before ALL insurance companies stop accepting paper invoices.
What’s in it for me?
A very simple, the ENT consultant surgeon will NOT get paid unless he submits his claims electronically. Paper invoices will be returned unprocessed and unpaid.
But, as MHM advised the prospective client, none of this is as onerous as it appears. The key to invoicing electronically is actually identical to paper invoicing. In both cases the details MUST be accurate. Take for example a current MHM client – a gynae, who previously submitted invoices in paper form but frequently omitted the patient’s policy number and/or the patient’s date of birth. The failure rate of paper invoices was over 26%. Since MHM has invoiced electronically for him the failure rate is less than 1%
The insurance company was previously forced therefore to check all the details at their end. Thus the invoice was delayed and possibly returned to the gynae with a request for more information. In other words it was delayed, as the discipline to successfully complete medical invoicing was not present.
Now consider processing the same gynae claim electronically. ALL electronic submission requires as mandatory that details are complete. If they are not the claim will NOT be accepted. This does not mean it will be paid. It does mean if the details are correct the claim has been accepted for consideration.
So, from the ENT consultant’s point of view and indeed that of the gynae what appeared to be onerous was actually in his own best interests.
Thus:
Why should I? – You’ll get paid quicker
What’s in it for me? – You’ll get paid quicker
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