Sunday, September 26, 2010

Electronic claim submission advantage

Benefits of Submitting Electronically

To avoid returned or incorrectly processed claims, providers should ensure they are submitting the
correct version of the CMS–1500 claim form. NAS encourages providers to submit their Medicare
claims electronically. As part of the Health Insurance Privacy and Accountability Act (HIPAA) and the Administrative Simplification Compliance Act (ASCA), Health and Human Services (HHS) is prohibited from paying Medicare claims that are not submitted electronically after October 16, 2003. This provision of the ASCA applies to most healthcare providers. For further clarification, please visit and search for the term “ASCA” to see a list of questions and answers related to this topic.

As a reminder of the main benefits of electronic claim submission, we have included a few ways in which the exchange of electronic data can improve the overall claim/payment cycle:

Quality – A standardized electronic claim format ensures consistency, reducing the opportunity for errors in data entry and processing. It also allows submitters to exchange electronic data with multiple payers using the same data format.

Fiscal Responsibility – There will be a reduction in paper, postage, and administrative costs. Also, your cash flow can be significantly improved because Medicare claims submitted electronically can be paid 14 days after receipt, as opposed to a minimum of 28 days for paper claims.

Process Improvement – EDI ensures fast, efficient exchange of information, which helps streamline daily processes. This gives time back to all parties involved!

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