Lifecycle of a Claim

The image below illustrates the ideal life cycle of a claim, from the time it is created until all money has been collected for the claim. In order for claims to be approved and paid when without denial, check the accuracy of the following things:

  • Patient demographic and payer (insurance) information needs to be captured accurately.
  • Billing rules and expected reimbursement schedules need to be set up accurately.
  • CPT codes needed have been added.
  • All the appropriate payers have been added to the fee schedule.
  • Benefits need to be verified.

Related Topics:

Claim Processing Overview

Top 10 Reasons a Claim is Denied

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