Claims Follow-up

HIPAA Standard 835 remittance files are processed via electronic file transfers and all denied claims become subject to review and follow-up; actions are taken based on established procedure and appropriately.

Resolution Specialists contact payers and aggressively work each outstanding claim. Detailed reports are generated by payer to identify unpaid claims more than 30 days old.

Follow-up procedures range from submitting a claim to a secondary insurer, re-submission based on corrected information and documentation, to ultimately transferring the balance to the patient for resolution.