Helping Managed Care Agencies Submit Accurate Claims for Individuals with Disabilities

Reducing your managed care agency aged deliverables is a significant problem for many organizations out there – reimbursements are one of the main ways for agencies like yours to obtain funds for further services for individuals with disabilities. But how can organizations reduce the time is takes for the funds to come in? Let’s look at a few methods.

Reasons for Delayed Reimbursements

The main reason that agencies don’t get their requested reimbursements on time is because the claims were not submitted correctly the first time. This means that there were mistakes made in the process that resulted in the rejection of the reimbursement requests. Read on for common mistakes.

Common Mistakes Made on Claim Submissions

The most common mistakes made when submitting reimbursement requests are:

• Incorrectly formatted claim data
• Incomplete claim data
• Claim data that does not meet the funding source requirements for reimbursement

How to Avoid Making Claim Submission Mistakes

To avoid making claim submission mistakes that result in the loss of or delay of valuable reimbursements, follow these guidelines:

1. Make sure you understand the funding source requirements. If you don’t – call them and ask questions!
2. Create a system or database where all your data is gathered and update it regularly.
3. Create a usable, useful, and concise process for submitted reimbursement requests – and make sure everyone in your agency fully understands it.

How DCI Software Can Help

You know how to bill for reimbursement from the state; however, when your agency under-serves or over-serves through employee hours, you need a tracking system that can prevent losses from your budget. Direct Care Innovations (DCI) software can prevent this, helping your agency serve its audience without losing valuable funds. Here are a few of the ways DCI’s software can help:

• Configuration of business rules to meet any funding source requirements
• An Authorization Management Module which integrates with Time and Billing modules
• Efficient and accurate billing data
• Production of a billing file for accurate and complete claims that can be submitted immediately
• Expert implementation team for support and seamless workflow

DCI can help your agency reduce its aged receivables and source funding quickly and without repeated work. Our business management platforms serve healthcare providers and government agencies in the Medicaid, Medicare, private insurance, and managed care markets. At DCI, we pride ourselves on being able to meet each customer’s unique needs for authorization management. We care for our customers because we have a shared mission of creating opportunities for and with people.

Contact us to set up a demo!