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How Does RCM Relate to Claim Submission?

Submitting claims can be a complex and time-consuming task, but it’s crucial for maintaining healthy cash flow. Bluebird Medserv can assist by outsourcing your revenue cycle management, including claim submission. This service improves your clean claim rate, reduces outflow, and helps save you money while boosting profitability. From eligibility verification to account receivables and everything in between, Bluebird Medserv handles your entire billing cycle. This includes submitting claims to the clearinghouse and following up on any denials, easing the burden on you and your staff, so you can focus on delivering quality patient care.

The claims submission process involves extracting data from the commercial cycle engine into a searchable database, and resolving any discrepancies. Medical billers can correct erroneous claims during the "scrubbing" phase, which allows them to identify and fix mistakes. If any issues arise, the billing company contacts the insurance provider to ensure timely reimbursement. The insurer is responsible for making the payment, matching the procedures with the associated expenses within the eligibility limits.

A statement is the document a healthcare provider sends to your insurance company to request reimbursement. It details the medical services you received and is part of the claims process.

Benefits of Claim Submission

Before claims are sent to insurers, they go through a thorough review process to validate the information. We utilize the capabilities of case management systems to ensure accuracy.
A reimbursement request is submitted by you or your healthcare provider to your health insurance company whenever you receive goods or services that are considered eligible for coverage.
An insurance payout refers to a request made by a customer to a medical insurance company, asking for payment or coverage for an incident or event covered under their policy.