The healthcare claim payment workflow is a complex process – from initial claim entry through to payment. The claim follow-up process has multiple steps that each require your attention: entering a new claim, resolving claim scrubbing errors, submitting the claim to the payer electronically or by paper, researching claim rejections, and appealing denials. This document provides guidance on when and how to move a claim through the process.
Please note: while several of the steps in this workflow involved automated processes within the ProviderSuite software and at the clearinghouse and the payer, you must still monitor those claims and take action.
Read the attached document for further guidelines on claim follow-up.