Claim Coding Services

The claim creation process begins with demographics entry and insurance verification. We gather all necessary information for generating an encounter, including demographics, insurance details, and ICD/CPT codes, either by scanning documents to our billing team or receiving them in packages. This is essential for accurate claim coding within our medical billing services. 

Once the information is collected, claims can be created using two methods: 

1. **Manual Claim Entry**: Claims are entered directly into the PM system from a route slip or superbill. Prior to generating any claim, we conduct a thorough insurance verification to confirm the patient's eligibility. During the ICD/CPT entry, various online tools are utilized to ensure that correct claim coding is applied, including modifiers, units, and charges. 

2. **Auto Generation**: Claims are automatically generated from the appointment scheduler. ICD/CPT codes, modifiers, and units are integrated into individual patient appointments alongside demographic information and patient insurance details. If copayments are included in the appointment information, they are directly transferred into the encounter. At the conclusion of the auto generation process, auditing of the newly created claims is performed before submission, ensuring compliance and accuracy.