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Accident claims have become very common these days

Accident claims have become very common these days

There are various categories of claims which are made and each one of the claims have their own methods and procedures which need to be kept in mind while thinking about claiming compensation on those grounds. While most of the times people prefer to hire the professional services of the claim experts, it is always a good practice to know the basic requirements of each category of claim so that if the need arises and the claim solicitor is not readily available to be present on the scene of the event, the person who is going through the accident can gather all the relevant information to be able to claim compensation.

There are different types of accident claims which are available for the people to claim in case they suffer from the repercussions of such accidents:

  • Claim related to office injuries.
  • Accidents in the factories which give way to industrial claims.
  • Claims related to car accident injuries.
  • Claims which deal with road accidents.
  • Motorcycle accident claims
  • Claims which relate to personal accidents.
  • Traffic accidents.


All the above categories of accident claims have their own set of detailed documentation and evidence that is required to be able to prove the fact that a claim is being requested due to the genuine requirement of compensation. There are some basic rules which need to be kept in mind when a person is looking forward to claiming compensation: Firstly whether it is an accident on the road or an accident at work, the person who has suffered in the accident should try and take down all the details of the accident, the time, the date, the location etc. If it’s a accident at work it should be noted in the accident record book of the company and if it is a accident on the road the person concerned should have the police note down the details of the accident along with the name, phone number and address of the people involved in the accident.

Notifying the insurance company within 24 hours along with arranging for someone to click the photographs of the location where the accident occurred is another important factor which can go a long way in helping people claim compensation. Often people like to take care of the compensation procedure on their own however it is always better to hire the services of the no win no fee based claim solicitor instead of trying to deal with the detailed paperwork on their own.

Since the claim solicitors are qualified professionals who are experts at handling the compensation cases, they stand a stronger chance of winning the case for their client in comparison to the situation where the client tries to follow the ‘Do It yourself” policy. Moreover the fact that the solicitor will get paid only if he wins the case, makes sure that he/she puts in all that he/she has to win the case.The best way to reduce outstanding receivables in a medical provider’s office is to make sure that claims being sent out are clean. Clean claims require less effort in collecting payment and result in faster payments. Claims with errors come back as denials and then need to be corrected, resulting in a delay in payment for services, and possibly no payment at all. After all, 42% of denied claims are never appealed or corrected.

Most provider offices do not have the time or the manpower to take care of denials in a timely fashion and it is one of the largest sources of lost money in a medical office. Sending out clean claims results in over 90% being paid on the first submission, leaving less than 10% of claims to be denied. By eliminating the avoidable errors, the real issues can be addressed and less money will be lost. One good way to ensure clean claims is by having a good claim scrubber in place. Many billers do not even know what a claims scrubber is but it actually influences your receivables in a huge way.

A good scrubber analyzes the data that is on the claim and compares the data to its rules engine before the claim is submitted. There are several levels of scrubbing and good claim scrubbers will analyze data on many levels. The most basic scrubbing function is to make sure that all required data is present. For example, it will check to make sure a name, valid date of birth, insurance information and id number are present. It will also verify that there is a date of service and a procedure and diagnosis code. But it may not verify if the data is accurate. For example, a basic scrubber may not notice if a date of service entered was mistyped and is for an obviously incorrect date, such as 04/01/2001. To a biller it is obvious that the entry person made a typo, but a basic scrubber may not catch this.

Another example is if an invalid insurance identification number is entered. Medicare identification numbers are a social security number followed by a letter, sometimes also followed by another number. If the person entering the claims makes a mistake and misses one number, a basic scrubber may not notice. But a good claim scrubber would pick up that there were only eight digits instead of nine, giving the user a warning that the claim may have an error.

Today claim scrubbers come with many more capabilities. They not only verify required data is present, but they also analyze icd-9 and cpt codes. They use rules from CMS and other major insurance carriers to detect mismatches and invalid combinations. Warnings will be given if data does not appear to meet carrier guidelines.

Now with web based software the claim scrubbers have improved even more. With the use of data mining a claim scrubber can build on its own knowledge base by continually reevaluating the adjudication rules of different payers. The claim scrubber is constantly improving its own quality of scrubbing capabilities. With this type of scrubbing capability a provider can reduce the percentage of human error and greatly improve the number of clean claims submitted.

Most practice management software systems with electronic claims capabilities come with some form of a claim scrubber. It is important to know how complete the claim scrubber that you are utilizing is. A good claim scrubber can have a huge effect on the accounts receivable of an office.

When we switched from a server based practice management system to a web based system we found that the claims scrubber on the web based Xena Health system caught up to 50% more errors that would have caused denials. The claims scrubber on our old system would have allowed those errors through creating much more work on the back end.


About MD Kawsar

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