FREE Electronic
Claims Through Clinic Pro Software
Clinic Pro Medical
Software submits electronic claims FREE to
Medicare and BCBS whenever possible. There are
no clearinghouse fees when you bill direct.
Whether electronic claims can be sent free in
your state depends on BCBS and Medicare in your
state. Ask our sales representative.
If
free claims are not available, we can transfer
claims via a number of different clearinghouses.
Electronic claims:
it's up to you how you want to send them.
Electronic Claims -- The "Bottom Line" Answer
Unless you operate a cash practice, you cannot
collect 100% of your fees. That is a fact of
life. Unfortunately, most chiropractic
physicians cannot afford to operate a cash
practice so they are forced by economic reality
to submit insurance claims. To survive as a
businessperson, you must maximize your insurance
reimbursement while minimizing the costs of
collecting that same reimbursement. Filing
insurance claims electronically can
substantially reduce the collection costs and
create a healthier bottom line.
There are three
major cost advantages of electronic claim
submission:
-
Less cost per
claim.
There is an automatic "fixed cost" per claim
when filing hardcopy claims. Even if the
computer prints your hardcopy claims so that
they are not being typed individually, the
costs add up quickly. Each hardcopy claim
requires computer time, printer supplies and
paper or the HCFA form itself. These
supplies are relatively inexpensive, about
.07/claim. However, when you add the labor
costs required getting HCFA forms ready for
mailing (preparing the printer, folding,
stuffing envelopes, filing), the costs
accumulate quickly to an estimate of
65/claim. Once you add postage at.33/claim,
the average hardcopy claim costs to $1.00-
$1.50 to send. If you get reimbursed $50.00
on your $80.00 claim, it has cost 3% to 4%
of your reimbursement to collect your money.
Of course, this scenario assumes that there
were no errors and that the insurance
company pays your original claim. If the
original claim gets rejected, the cost of
collecting your money escalates. Let’s
assume that your office is very efficient
and that it only costs .60/claim to file
hardcopy. Using this conservative estimate:
500 claims/month x .60 = $300/month.
Obviously, the monthly cost increases with
each claim because it is a fixed cost. By
comparison, unlimited electronic claims can
be sent free with the right software or at
minimal charge of approximately $25/month.
There is no fixed cost per claim when filing
electronically – that creates a huge cost
differential even for small practices.
-
Faster
turnaround.
Hardcopy Medicare claims are held for 27
days from the day they were received;
electronic Medicare claims are processed in
14 days. Likewise, there is a similar
difference in turnaround time for commercial
carriers. A quicker turnaround means that
the money received could be invested; money
that is invested draws dividends or
interest. In simple economic terms, that is
the "time value" of money. By allowing
insurance carriers to hold your money for
two to four weeks longer, they earn the
interest -- not you. Because this cost is
intangible, it is more difficult to
calculate. On a monthly income of $20,000,
the cost of lost interest income could range
between $100 - $300/month.
-
Immediate
feedback on edit/rejections.
There is
nothing more frustrating than waiting six
weeks for payment of a hardcopy claim only
to find that it was rejected due to a
clerical error. Then, the process begins
again. You have to create a corrected paper
claim (incurring the same fixed costs as the
original) and wait another six weeks
(allowing the insurance company to earn more
interest on your money.) With electronic
claims, you can usually receive feedback on
the status of the claims within 24 hours. If
a claim contains errors that will cause
rejections, it can be immediately corrected
and re-submitted. No wasted time, no
duplication of effort. The cost of
rejections fits into the intangible category
since it incorporates both of the costs
above.
Most practitioners
accept the premise that filing for insurance
reimbursement is an economic reality; the method
of claim submission becomes the question. Take a
moment to crunch through the numbers for your
office. We have prepared two very conservative
estimates of cost depending on the volume of
monthly claims. If you actually calculated the
cost of filing hardcopy claims, it would
probably be much higher than the following
figures:
1000 Claims per Month |
Month |
Annual |
Per-claim Cost |
600 |
7,200 |
Time value of held funds |
300 |
3,600 |
Avoidance of rejections |
200 |
2,400 |
Total cost |
$ 1,100 |
$ 13,200 |
Electronic claim submission is very efficient:
it is the "bottom line" answer for most medical
or chiropractic offices. It is the key to
effective practice management software. |