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What documents does a professional billing company require to submit claims to clearinghouse?

It is important to know what documents are required for a third party billing service to submit claims. After choosing the local billing service, you must send patient demographics and insurance information of new patients and patient with change of demographics and insurance information.

All above information will be available on patient registration form or hospital face sheet. Encounter sheets consisting of information about procedures and diagnosis codes performed during visit. Explanation of Benefits and stubs from the patient bills will be required for posting payments.

The medical billing company may regularly require above said documents for timely filing of paper claims in compliance with HIPAA regulations.

Every professional billing agency requires CMS 1500 and UB-04 documents for accelerating electronic claims submission process. The e-claims helps to speed-up claim creation and scrubbing and saves much time for human oversight to increase accuracy of claims.

Your medical billing service provider may additionally request to share access to electronic health records EHR/electronic medical records (EMR)/practice management systems (PMS) for scrubbing and filing claims to clearinghouse electronically.

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