Wiki Help with claims!

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aleciaaa10

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Philadelphia, PA
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I'm currently working in HCC coding, but I know that one day I will go back to the physician side. The problem is that a lot of the job postings for the physician office want coders as well as billers. In my previous experience in a physician office, I was auditing the charts and entering CPT/ICD codes, but nothing on the billing side. We had a biller who would let me know what codes weren't being covered by which insurances and she would send the claims and do the follow up.

I honestly have no idea how to submit claims or do denial and A/R followup. Does anyone have resources for me to learn more about these types of things? I would really appreciate it!
 
claims

I would suggest to get with your supervisor regarding how to submit claims. Medicare, for example, only accepts claims electronically. Does your employer have a RCM software? You need to find out about which clearinghouse you use. Usually, these are connected.

Sounds like you need additional training from your employer.
 
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