4 keys to improving your clean claims rate

Practices can take review measures to improve their rate of "clean claims."

Acknowledging "clean claims" is a part of the healthcare modernization process. Practices that take the time to address these claims and submit them properly could improve their revenue cycle and address problems with denials. Paying close attention to data and tracking it accurately can lead to a higher rate of claims with no errors that were reimbursed correctly, as Mary Guarino explained in a new HIMSS post.

Since addressing these claims could require more effort or staff from the provider, it helps to have a plan in place before trying to "clean up" the claims an organization handles. Here are four ways to get started, based on the best practices in these situations.

  1. Promote training and education: All it takes is one error for a claim to suddenly be "unclean." This could be anything from wrong information to an invalid code, and could seriously hold up the revenue cycle. Encouraging staff to learn the proper way to prepare claims can start the process off on a good foot.
  2. Follow claims throughout the cycle: When a problem with a claim occurs, who is at fault? Claims and denials leave a trail that smart organizations should follow to hold the right people accountable, as Guarino also said.
  3. Screen new software for security: Updating older technology is a good start to handling large numbers of claims. Apps and other systems can make scanning bills easier, but make sure that all systems are compliant and don't put anyone within the organization at risk.
  4. Improve quality checks: Just as practices update their computer systems, they also need to adapt all quality measures. It should be just as easy to manage a newer system as an older one, and keep it up to expectations.

To prepare your organization for payment reform and protect against violations, contact a compliance consulting specialist today.

Leave a Reply

Your email address will not be published. Required fields are marked *