Why would an office prefer to submit claims for patients instead of having the patients submit their claim forms directly to the insurance carrier?
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Asked June 13, 2011
In many cases, allowing the office to submit claims means the claim is processed faster and more accurately. You are still entitled to a copy of the claim being submitted if you wish, but the insurance companies and health providers often work closely together and can push the claim through faster by eliminating the patient from the filing procedure. Today, many health care providers have the electronic equipment in the office to file claims automatically daily, weekly or monthly, using the forms filled out before and during the medical procedure.
When the medical care provider submits the claims, electronically or through an accounting agent or service, the information is more likely to be accurate and presented correctly. This saves time spent in verifying claim amounts, or resubmitting a claim because of simple errors on forms filled out by the patient. This protects the patient against incorrect or inadequate payments and reduces the overhead of operating the health insurance industry be reducing the total amount of time spent per claim.
From the patient's point of view, allowing the office or care provider to submit health care claims takes some of the anxiety out of the medical process and allows the the peace of mind to know the forms are being handled by someone with experience in the process. It is still important to keep track of the claims and make sure that the information is being submitted correctly, but the possibility of claim denial is much lower. Besides, the patient has enough to worry about in these situations, and passing on the claims process to someone else allows them to concentrate on healing.
Answered June 13, 2011 by Anonymous