Everything You Need to Know About Insurance Claims Submission

Jovin Richard
May 9
2 min read

Mastering Claims Submission for Faster Reimbursement

Insurance claims submission is a critical part of the revenue cycle in any healthcare practice. Submitting accurate, timely claims not only speeds up reimbursement but also reduces denials and administrative headaches. Whether you're billing for primary care, specialty services, or mental health, a solid understanding of this process is essential.

What is Insurance Claims Submission?

It’s the process of sending a medical claim to an insurance company for services provided to a patient. The claim includes detailed information about the patient, the provider, diagnosis codes (ICD-10), and procedure codes (CPT/HCPCS). The insurer reviews the claim to determine payment eligibility based on the patient’s plan.

Key Steps in the Submission Process

Patient Registration and Verification Accurate demographic and insurance data collection is the foundation of a clean claim.
Medical Coding and Charge Entry Ensure codes are precise and reflect the services provided. Mistakes here often result in denials.
Claim Creation and Scrubbing Use billing software to flag common errors before submission.
Submission to Payer Claims can be submitted electronically (EDI) or, in some cases, on paper.
Payer Adjudication The insurer evaluates the claim and issues payment, partial payment, or denial.
Posting and Reconciliation Payments are recorded in your system, and denials are addressed with appropriate action.

Common Causes of Claim Denials

Inaccurate patient or insurance details
Incorrect or missing codes
Lack of authorization or referral
Missed timely filing deadlines

How AccordPro Streamlines Your Claims

We handle claims submission from start to finish, ensuring every claim is clean, timely, and tracked until paid. Our billing experts help practices:

Improve first-pass claim acceptance rates
Track and follow up on outstanding claims
Minimize delays due to errors or missing information
Increase cash flow and reduce A/R

Want to Reduce Denials?

📞 Call us at 425-215-0517