Benefits Of Electronic Claims

Benefits Of Electronic Claims Submissions At (Highmark Billing & Payment)

Benefits Of Electronic Claims – convenient, confidential, and operational around the clock. All it takes is a computer, the proper software, and an Internet connection for electronic claims submission. Instead of printing, bundling, and sending paper claims through the mail, simply enter and store claims data through your office computer. Highmark’s claim processing system places a higher priority on claims filed electronically. Electronic claims will typically process in seven (7) to fourteen (14) calendar days, whereas paper claims will process in twenty-one (21) to twenty-seven (27) calendar days.

The payment progress targets defined above that are used in Pennsylvania are in compliance with timely claims payment regulations defined by Pennsylvania’s Act 68, and reflect processing of clean claims that do not require manual intervention or investigation. The payment progress targets defined above that are used in Delaware are in compliance with timely claims payment regulation  defined by Delaware Insurance Regulation 1310, and reflect processing of clean claims that do not require investigation.

In West Virginia, the payment progress targets defined above are used and are in compliance with the timely claims payment regulations defined by the Ethics and Fairness In Insurer Business Practices Act, W.Va. Code §33-45-1 et seq., commonly referred to as the “Prompt Pay Act”, and reflect processing of clean claims that do not require investigation.Electronic claim submission increases staff productivity by speeding claim preparation and delivery. Many of the paper claim processes are eliminated such as form printing, bundling, postage, and mailing. Many errors experienced in the keying and processing of paper claim forms are reduced or eliminated. Electronic claim submission means greater claim acceptance rates and reduced staff time in claim research and resubmissions.

Electronic submission provides the added benefit of both claim preparation and delivery at your convenience. Postal service hours of operation or delays do not limit your productivity. Electronic claims can be submitted 24 hours a day, seven days a week, 365 days a year. It is safe, immediate, and direct to Highmark. EDI security standards are in place to ensure your claim data remains confidential and secure.

HIPAA-compliant 1500 (837P) and UB (837I) claim submission transactions are also available to participating professional providers and facilities in NaviNet.

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