eClaims are insurance claims that are submitted to the insurance carriers through electronic transmission. The information on eClaims are the essentially the same information compared to those submitted through CMS1500 paper forms. So instead of filing claims on paper, the billing department file claims in electronic format. There are a few components administrator and doctors should consider when dealing with eClaims.

Equipments

• Computer: Since the claims will be sending through electronic transmission, a computer is required for data input.
• Networking Equipments: devices such as dial up modem or best broadband router, DSL modem, and cable modem is required to gain access to the internet. Also it is best to go with a reliable & fast broandband internet service provider.

Software

• Billing Managment Software: Research your software carefully before making a purchase decision because the software will be an effeciency factor in the eClaims filing process. We will explain further why the billing software can be critical in the filing proccess. Look for our Billing Management Software article.
• Electronic Format and Interface: Majority of electronic claims are sending through text based ANSI format, and billing management software will determine the functionality of these format. Check out the list of electronic format that currently available for electronic filing. Interface is another important factor in electronic medical billing. Billing management software needs to have compatible interface with charting software to synchronize patient's information from charting software. Information such as demographic, diagnosis, and procedure codes can be easily obtained through the interface.
  

Clearing House

• Why Clearinghouse? A clearinghouse exists to check if the information on eClaims and eClaims' format are compliance to the specifications of the insurance carriers. The clearinghouse will reject the eClaims if some information is invalid or missing and accept the eClaims if everything correct according to specifications. Rejection or acceptance reports will be send to the billing client before submit the eClaims to the carriers. Read more
• Agreements and Contracts: Agreement and contracts with the clearinghouse is required before the billing client sending eClaims to the clearinghouse. The clearinghouse will state their terms and conditions to the client, and the fees associated for processing the claims. Now, it is best to do some research before going with a clearninghouse. We will also investigate this matter further on our upcoming articles.

     The advantages of electronic claims fast and secured transmission, postage free, and quick response from insurance carriers. The downside to electronic claims is the keeping up with latest technology and fees & charges from clearinghouse. However, the turn around time for electronic claims is much faster than paper claims. The practice get paid faster from insurance carriers by filing electronic claims. In the end, uninterrupted cash flow is what keeps a practice or any business operate smoothly everyday.

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