The majority of claim rejections occur due to data entry at patient check in. We will work with your staff to help verify your patient’s information before they are even seen. This ensures your claims are paid as quickly and efficiently as possible. Our billing clients are seeing a First Claim Resolution (FCR) of over 93% with a final collection percentage of over 97%!
Q. What does First Claim Resolution mean and how does it affect my practice?
A. First Claim Resolution means the claim is PAID the first time the claim is sent. This means your practice is getting paid faster with fewer follow-ups and collection inquires.
Q. I’ve seen the term First Pass Claim Acceptance, what’s the difference?
A. First Claim Acceptance or First Pass Claim Acceptance means the claim is received by the insurance company. This doesn’t mean the claim was sent to the correct payer or that the patient information on the claim was correct. These claims may or may not be paid based on this first claim.
Q. What’s the difference between collection percentage and first claim resolution?
A. Our First Claim Resolution is very high, but in the medical industry insurance payers always seem to find a reason to deny a claim. If a claim is denied for any reason our collections team will rework the claim to ensure payment is received.
Q. What kind of data entry errors are most common?
A. The most common data entry errors are patient policy numbers, group numbers, social security numbers, or patient names being incorrect. Our software’s eligibility feature will verify that your patient’s insurance is current and that this information is entered correctly. Another common error is missing authorization. We can also setup features in the software to alert your staff when a visit will need authorization based on the type of visit and the patient’s insurance.