Claim Submission

Claim Submission & Clearinghouse Management

Clean, timely claim submission is essential to healthy revenue. Incorrect or non-compliant claims are rejected or denied — costing time, resources, and cash.

Common Problems:

  • Missing modifiers

  • Incorrect member IDs

  • Improper place-of-service

  • Uncaptured secondary claims

  • Slow clearinghouse cycles

Our Solution:

  • Automated claim scrubbing

  • Payer-specific rules engine

  • Batch submission via trusted clearinghouses

  • ERA reconciliation

  • Fast rejection/resubmission workflows

Process:
Superbill → claim scrub → submit → monitor ERA → reject handling/appeal → payment posting

Benefits: Higher first-pass acceptance, shorter days in A/R, fewer manual corrections.

KPIs We Track: First-pass acceptance rate, average claim turnaround, rejection rate, resubmission time.

FAQ:
Q: Which clearinghouses do you use?
A: We partner with multiple enterprise clearinghouses to match payer connectivity for speed and reliability.