Claim Coding

This is facilitated either by scanning documents to our billing department or by receiving packaged submissions containing all requisite information for encounter generation, including demographics, insurance particulars, and ICD/CPT codes.

Once the data is obtained, claims can be generated using two methodologies:

• Manual Claim Input: Claims are directly entered into the PM (Practice Management) system from either a route slip or a super bill. Prior to claim generation, we verify the patient's insurance eligibility. During the input of ICD/CPT codes, we utilize various online resources to ensure accurate coding, incorporating modifiers, units, and charges.

• Automatic Generation: Claims are automatically generated directly from the appointment scheduler. ICD/CPT codes, modifiers, and units are inputted into individual patient appointments along with demographic and insurance information. Any copayments recorded in the appointment details are seamlessly transferred to the encounter. Even after the automated generation process, newly created claims can undergo auditing before submission.