Claim Processing
Printing paper claims and submitting electronic claims
Improve cash flow and save time by processing claims with Kareo. You can send electronic claims to over 2,500 insurers, print paper claims, receive claim processing reports, and resolve rejections and denials. Kareo helps you process claims accurately and efficiently to safeguard your physician's cash flow against costly disruptions.
Submit Electronic Claims
You can use Kareo to send primary and secondary electronic claims to more than 2,500 government payers and commercial insurance carriers nationwide. We help you set up connections to thousands of commercial insurance companies and closely manage the enrollment process for government and Blue Cross and Blue Shield payers. Once you set up your master insurance list, you can submit claims immediately.
Print Paper Claims
Some insurance claims, such as those that require additional paper attachments, must need to be submitted on paper claim forms. You can configure different claim forms for primary and secondary billing scenarios. For most insurance companies, you'll use our standard CMS 1500 Form or our newer CMS 1500 Form with support for the new National Provider Identifier (NPI) numbers. For certain payers, you can also tap into our library of state-specific and workers' compensation claim forms. Finally, you can customize the provider and group numbers that appear on your forms using advanced settings.
Receive Claim Processing Reports
Kareo provides multiple levels of reporting as your claims make their way through the claim submission and adjudication process. Once you submit your claims, our systems automatically review all of your claims and return internal validation reports to highlight claims with missing information, such as missing provider or group numbers, missing patient information, or incorrect policy numbers. Once your claims pass our internal validation, we forward your claims through one of several clearinghouse partners who also review your claims and return daily reports that highlight claims that have been rejected for various payer-specific reasons. Once your claims are delivered to payers, the payer may respond with reports highlighting claims that have been rejected for various reasons prior to the adjudication process. Finally, you may receive electronic remittance advice (ERA) reports once payers process your claims and issue payment.
Resolve Rejections and Denials
Kareo automatically posts and tracks information about rejections and denials that have been reported back to you on claim processing and electronic remittance reports from insurance companies. You can use rejection and denial management reports and our collections tools to efficiently resolve rejections and denials by gathering missing information, correcting data entry errors, and resubmitting claims within each payers' timely filing deadlines.
Set up Advanced Business Rules
You can take advantage of our advanced claim printing rules engine to handle attachments, workers' compensation billing scenarios, or other unique situations. You can configure different claim forms per state, billing scenario (e.g. Medicare, workers' comp, etc), and/or procedure code. You can set up rules to print and pre-collate attachments, send copies of claims to multiple recipients, and even print envelope labels.
