If you have any part in running a medical practice, you can go home each night knowing you have made a good difference in the world. However, we understand that you may go home feeling stressed, frustrated, and worried. Any business has its challenges, and the medical profession is no exception. As veterans of the medical world, the team at Complete Practice Services more than understands the hurdles you and your team face each day. That is why we provide excellent electronic billing and records programs. We know you have enough on your plate without having to worry about lost slips of paper and bad handwriting. We also know that you can’t afford to use a program that glitches or loses information. The health and privacy of your patients hangs in the balance – along with your practice’s reputation.
Confusion produces of chaos, especially when it comes to information. That is why we have taken the last few blogs to share some of the most common medical billing terms and what they mean. We want you and your team to know exactly what you are doing, because it is the best way to avoid mistakes. In today’s, blog, we are going to share some last terms that may or may not look familiar to you.
This is an insurance claim that is processed punctually without any errors. There’s nothing better than a clean claim for a care provider. The provider gets reimbursed fully and quickly without the complexity of appeals and other processes. Clean claims are so important, businesses called “clearinghouses” are kept quite busy providing clean claims. For many providers, the third party cost is worth it in order to be able to have clean claims.
We just mentioned this type of organization, but we want to provide some more detail. A clearinghouse is a third-party step in the billing process. It is completely separate from the insurance and the provider. It reviews, edits, and formats insurance claims (a process called “scrubbing”) before sending them on to insurance companies.
Electronic Remittance Advice (ERA)
In our last blog, we defined the explanation of benefits (EOB). Electronic remittance advice is an electronic version of the EOB. It explains how much of a claim the insurance company will pay, and if the claim is denied, it explains what went wrong.
This is an arrangement between the insurance payer and the patient. It splits payment by percentage. It is often confused with copay, but it’s different. A copay is a fixed amount, but co-insurance is a fixed percentage. When you’re looking at the percentages, the insurance payer’s percentage is first.
The team at Complete Practice Resource is proud to offer Santa Barbara premier EHR services and beyond. Not only do we help you protect your patients’ information, we help you schedule appointments and become more cohesive as a practice. We understand better than most the burden of information in the world of medicine, and we are honored to help. Contact us for programs as well as training today!