Checking demographic details of patient and make sure the front desk should select the proper regulatory policy (DHPO or RIAYATI)
- Proper documentations are entered in the Chart/ EMR/ Claim form by the doctors.
- Supporting details/ justification available in EMR of all investigation done.
- Checking all CPT codes entered are correct based on CPT guidelines.
- Checking excluded ICD and CPT based on Coding guidelines.
- Approved services and rendered services are match.
- Ensuring all requested investigations are done and invoiced.
- Check the claim with correct Receiver and Payer name before finalizing the bill.
- Check the claim with correct Patient Copay application.
- Ensure all claims are submitted to insurance company.
- Check the payer’s name, rate plan and plan name selected properly.
Submission Supervisor Checklist & Responsibilities
- Maintain Production sheet
- Allocate production claims details to submission team based on the claims generated data.
- Every month create production xl and document each staff wise daily production count.
- Sharing of daily production details and claims status to Sir JP.
- Maintain monthly Claims status
- Downloading 16 facilities claims generated count and update in the claim’s status XL daily.
- Based on the data maintain finalized claims and pending claims details in the same xl.
- Maintain Correction claims details
- Monthly Create new folder in the sharing folder to maintain correction details for each centre wise.
- Share the correction details to respective clinic team.
Checking demographic details of patient and make sure the front desk should select the proper regulatory policy (DHPO or RIAYATI)
- Proper documentations are entered in the Chart/ EMR/ Claim form by the doctors.
- Supporting details/ justification available in EMR of all investigation done.
- Checking all CPT codes entered are correct based on CPT guidelines.
- Checking excluded ICD and CPT based on Coding guidelines.
- Approved services and rendered services are match.
- Ensuring all requested investigations are done and invoiced.
- Check the claim with correct Receiver and Payer name before finalizing the bill.
- Check the claim with correct Patient Copay application.
- Ensure all claims are submitted to insurance company.
- Check the payer’s name, rate plan and plan name selected properly.
Submission Supervisor Checklist & Responsibilities
- Maintain Production sheet
- Allocate production claims details to submission team based on the claims generated data.
- Every month create production xl and document each staff wise daily production count.
- Sharing of daily production details and claims status to Sir JP.
- Maintain monthly Claims status
- Downloading 16 facilities claims generated count and update in the claim’s status XL daily.
- Based on the data maintain finalized claims and pending claims details in the same xl.
- Maintain Correction claims details
- Monthly Create new folder in the sharing folder to maintain correction details for each centre wise.
- Share the correction details to respective clinic team.
College Diploma
AAPC / CPC coding