ASSURED BUSINESS SUPPORT SERVICES    

P.O. BOX 1226, EASTON  MA  02334

Telephone: (508) 230-3377     Fax: (508) 230-1771

                                     

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ELECTRONIC CLAIMS PROCESSING FACTS

bullet Only 40% of claims are electronically processed. It is estimated that more than 6 billion insurance claims are filed each year or around 500 million claims per month.
bullet Medicare alone receives more than 500 million claims per year.
bullet Electronic Claims Processing reduces payment turn-around time by shortening the payment cycle.
bullet About 30 to 35% of all paper claims are rejected due to typos, errors and omissions. 
bulletMore than 220 million Americans are covered by some form of health insurance. The average person accounts for 6 physician encounters per year.
bulletElectronic Claims Submissions have been mandated by Congress:

Congress passed legislation on administrative simplification called the Health Insurance and Portability and Accountability Act of 1996 (HIPAA). This act, signed into law in August, 1997 calls for the electronic transmission of core financial and administrative transactions, including billing, electronic claims processing, eligibility, and payment and remittance advice.

The Secretary of Health and Human Services has 18 months to adopt standards for data exchange so everyone (carriers and providers) submit and receive information in the same format. Health insurance carriers and providers have another 24 months to comply. The passage of HIPAA is considered to be a landmark victory for the advancement of computerization in healthcare.

Healthcare providers must be in compliance to the electronic claims transmission standard code sets by October 16, 2002 or have filed a one year extension by this date. Contact Assured Business Support Services for assistance. 

 

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