Counting Claims for Per Claim Price Plans

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.
    • Related Articles

    • How to Delete or Void a Claim

      Deleting or Voiding a Claim Unreleased claims can be Deleted, Released claims cannot be Deleted, they can only be Voided. Released claims with payments applied cannot be Voided until those payments are reversed or removed. Deleting and Voiding are ...
    • User Guide - Billing Manager - Claims

      Billing Manager Claims In this section, we will discuss entering claim information into the Billing Manager. IMPORTANT Navigation within the Billing Manager application to move from one field to the next works best by hitting Tab on the keyboard. The ...
    • How to print 1500 Claim Forms

      Question How do you print out 1500 Claim Forms to send to the insurance carrier? Answer To print out a claim(s), first, you have to make sure you have clicked the Save Claim-Release button on all of the claims that you want to print. If claims are in ...
    • Delete Duplicate Instances of Insurance Plans

      Identify and Remove Duplicate Insurance Plans   If duplicate instances of the same insurance have been created, follow the steps below to delete the instances with no patients, active claims, or employers currently assigned to the plan. Generate the ...
    • Printing Multiple Claims from Pending Payer Paper Claims Bucket

      Follow these steps to print 08/05 1500 or UB 04 forms in bulk from the PracticeAdmin Billing applet.  Click the Pending Payer Paper Claims Bucket in the Today Screen to populate the list of claims that need to be printed. Click the Print button below ...