How Many Procedure Codes May Be Submitted On The Cms-1500 Mandated Electronic Claims Filing – Some Insurance Carriers Mandate Electronic Claims Filing

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Mandated Electronic Claims Filing – Some Insurance Carriers Mandate Electronic Claims Filing

They’ve been talking about it forever but it looks like it’s finally here. Insurance companies are beginning to mandate electronic submission of insurance claims. We received our first notice that medical insurance claims must be submitted electronically in 2007.

Many insurance companies have been trying to encourage providers to submit insurance claims electronically for years. They offer perks like faster payments, fewer requirements for approvals, and other benefits to providers. They also have providers visit provider offices to see why they are not submitting claims electronically and provide suggestions for ways to get their office to submit their claims. electronically.

Now we are actually seeing companies saying they will no longer accept claims on paper CMS 1500 or HCFA 1500 forms. Fidelis Care in New York is one of the plans that said they will no longer accept any paper claims in 2007. They state that they are over 80% electronic claims and not they will now accept any paper claims in 2007. If you are a participating Fidelis Care provider and you tried to submit your paper claims, they will be returned to you with a letter. They advise you to contact your provider rep and they will help you find a way to submit your claims electronically.

Fidelis Care is one of the first insurance companies I’ve seen that actually returns any claims on paper. Excellus BCBS tracks how many claims each provider submits on paper and if the number is over a certain amount each month, they send a representative to the provider to talk to the provider about why they are not submitting the claims electronically, but they don’t. return claims – however. New York Medicare states that all providers must submit claims electronically, but they allow enough separations that can be obtained in an office.

I think more companies will start following Fidelis Care in New York. It is a huge money saver for the insurance company to receive claims electronically. More and more companies are starting to return claims to providers when submitted the old way, on red and white paper forms!

Copyright 2007 – Michele Redmond

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