Healthcode’s automated validation is quick, straightforward and puts you in control. During the process, each bill is checked against the insurer’s validation rules to ensure the following details have been provided:
- The patient’s membership number, in the correct format for that insurer. For some insurers we check that the patient has an active policy
- The patient’s contact details: name, date of birth and address
- Treatment details: treatment date, treatment site, controlling specialist, procedure and fee charged.
Errors or missing information are highlighted there and then, which means the bill can be corrected and resubmitted in a matter of minutes.
Once a bill has been validated it is sent securely to the insurer for processing and the practice can see on-screen confirmation that the bill has been submitted successfully. The majority of bills that are cleared by the Healthcode system are ready for payment when they reach the insurer: pre pandemic we were clearing up to 28,000 bills per day.
Ultimately, this makes online billing and validation a more reassuring and immediate way to submit invoices. And if an insurer is satisfied that a bill meets its rules, they can and do pay more quickly which is great for your practice cash flow.
By contrast, if you are used to manually printing, posting or emailing each medical invoice to the insurer, you have no reassurance that it has securely and safely reached its intended destination and meets the insurer’s validation rules. The first you will know of a problem might be when the insurer contacts you with a query or when you notice that the bill has not been paid.
And this could be weeks later because invoices can only be checked and validated after they have been received and manually entered onto the insurer’s system. Any queries lead to the bills being suspended and placed in a queue for further investigation.
If you have not yet started e-billing, watch the video or see Healthcode’s Industry Guide to Private Medical Billing.