Counting Claims for Per Claim Price Plans
As someone who is on a Per Claim price plan, we wanted to clarify how claims are counted for purposes of your PracticeAdmin invoice - specifically that there is no charge for additional printed claim copies.
When you enter a new claim into ProviderSuite, it is counted once in the month the claim is originally entered into the system. The Per Claim fee includes the initial electronic submission of the claim and unlimited printed copies. While some billing systems charge per copy, with ProviderSuite, unless you electronically resubmit the claim, it is not counted again after that initial entry.
For electronically resubmitted claims, since the clearinghouse charges a transaction fee for each claim transmitted electronically, regardless of whether it is the initial submission or a re-submission, the claim is counted again for the purposes of invoicing in the month in which it is resubmitted.
For example, in a given month, you enter 15 new claims, electronically resubmit 2 claims entered in prior months, and print 10 claims entered in prior months to mail to payers, you are only charged for the 15 new and 2 resubmitted claims, not the 10 claims you manually printed.
And with your ProviderSuite Per Claim price plan, there is no charge for ERAs sent by the payer to you.
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