Clean Claims

With MedPro Services, you can be sure that your claims are being submitted in compliance with the most up-to-date billing and coding guidelines. We employ a three-tiered strategy for claims accuracy and expedited reimbursement:

  • Our data entry clerks perform a coding audit for accuracy prior to charge capture. This process includes reviewing the codes and diagnoses listed by the provider to determine accuracy, reviewing medical reports, and checking CMS guidelines.*
  • Claims are “scrubbed” by our practice management software, Healthpac, for possible coding errors prior to submission. No claim leaves our practice management system until all checks are completed and this initial process of error elimination is complete.
  • Electronic claims are “scrubbed” for a second time by our clearinghouse, ZirMed, employing up-to-date coding edits and an extensive database of insurance carrier claim requirements.

Claims Submission

It is our goal to ensure that all claims are submitting in the quickest, most efficient way possible. Quicker claims submission means quicker turnaround time and ultimately timelier revenue receipt. In the modern era, most insurance carriers accept claims electronically and when possible, we submit claims electronically. Our knowledgeable claims staff is also aware of electronic and paper medical records submission standards set forth by most insurance carriers. We also have the ability to print and mail paper claims on forms, such as the CMS 1500 for your professional claims and UB04 for your facility claims, when the need to do so arises. Our team is familiar with the bill submission requirements of most workers compensation carriers and is prepared to submit bills and medical reports in this manner.

Timely Filing

Almost all insurance carriers have a set claims filing submission time frame and this can vary greatly from carrier-to-carrier. The MedPro team is aware of the timely filing limit for all major insurance carriers and works to ensure that every claim we submit is within this timely filing limit.

* MedPro Services utilizes AAPC (American Academy of Professional Coders) guidelines to ensure accuracy with your submitted charges. All charges submitted will be verified against the CCI (Correct Coding Initiative) and with the LCD (Local Coverage Database) to ensure they are reimbursable.