{"id":6294,"date":"2008-10-15T04:26:47","date_gmt":"2008-10-15T09:26:47","guid":{"rendered":"http:\/\/magic1host.com\/blog\/2008\/10\/15\/use-clean-claim-laws-to-make-payers-actually-pay\/"},"modified":"2008-10-15T04:26:47","modified_gmt":"2008-10-15T09:26:47","slug":"use-clean-claim-laws-to-make-payers-actually-pay","status":"publish","type":"post","link":"https:\/\/magic1host.com\/blog\/?p=6294","title":{"rendered":"Use Clean Claim Laws to Make Payers Actually Pay"},"content":{"rendered":"<div style='italic;' class='uawbyline'>by Carl Mays II<\/div>\n<p>All 50 states currently have a Clean Claim Law. The effectiveness of the laws varies dramatically ranging from South Dakota which provides for no financial penalty to Texas where the penalty can go up to a requirement on the payer to pay billed charges; that&#8217;s right billed charges. <\/p>\n<p>The basic idea of the law is that a payer has to respond to a clean claim within a set time (usually around 30 days for electronic claims). In order to utilize the clean claim law effectively you must have a tracking system built into your medical billing process that flags:<\/p>\n<p>1. Which payers must abide by the clean a claim law (the laws do not apply to all payers), <\/p>\n<p>2. The date your practice initially submits each medical claim;<\/p>\n<p>3. Any events that legitimately give the payer more time to process the claim (for instance, a request for additional information);<\/p>\n<p>4. When your practice has taken actions in response to payer requests;<\/p>\n<p>5. The date when you received the payer&#8217;s final adjudication decision.<\/p>\n<p>The idea of systematically tracking all of this information may be daunting, but with a smart system design it is possible and most definitely a worthwhile undertaking. After submitting a few Clean Claim law violation reports you will see your claims pay faster. I have seen situations where payers have actually called just to assure the practice that claims will be quickly processed.<\/p>\n<p>One way to quickly get started using the clean claim law is to run a trial on a payer that you feel consistently takes more than 30 days to ajudicates claims. Find a small number of large claims for this payer that have gone past 30 days and then conduct a trial run with those claims. This will allow you to learn the fundamentals of how to submit and monitor complaints and see the results of your complaints.<\/p>\n<p>Copyright 2006 by Carl Mays II<\/p>\n<div class='uawresource'>\n<div style='italic;' class='uawabout'>About the Author:<\/div>\n<div class='uawlinks'>Carl Mays II, CEO of ClaimCare <a href=\"http:\/\/www.claimcare.net\">Medical Billing Services<\/a>, has spent the past 15 years improving the operations of his clients. To read more about selecting <a href=\"http:\/\/www.claimcare.net\">Healthcare Billing Services<\/a> subscribe to Carl&#8217;s <a href=\"http:\/\/www.meyouworld.net\" class=\"kblinker\" target=\"_blank\" title=\"More about Blog &raquo;\">blog<\/a><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>All 50 states currently have a Clean Claim Law. The effectiveness of the laws varies dramatically ranging from South Dakota which provides for no financial penalty to Texas where the penalty can go up to a requirement on the payer to pay billed charges; that&#8217;s right billed charges.<\/p>\n","protected":false},"author":1907,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[130],"class_list":["post-6294","post","type-post","status-publish","format-standard","hentry","category-outsourcing","tag-outsourcing"],"_links":{"self":[{"href":"https:\/\/magic1host.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/6294","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/magic1host.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/magic1host.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/magic1host.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1907"}],"replies":[{"embeddable":true,"href":"https:\/\/magic1host.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6294"}],"version-history":[{"count":0,"href":"https:\/\/magic1host.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/6294\/revisions"}],"wp:attachment":[{"href":"https:\/\/magic1host.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6294"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/magic1host.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6294"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/magic1host.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}