TRH | Demographic / Charge Entry

The Claim Creation process starts with Demographics Entry and Insurance Verification. Either through scanning documents to EMR / EPM / EHR or having it shipped in correspondences, TRH Business Team collects all the information necessary to generate an encounter (demographics & insurance information). We know that the Payers / Carriers offer various levels of health insurance coverage to their beneficiaries, and as a Medical Billing Professional, you must be able to understand payer coverage to gather information you need to prepare medical claims. Many payers or networks have standardized contracts that they offer to healthcare providers. To be paid for services, medical practices / billing service need to verify patient’s eligibility for Health insurance coverage, preauthorization and Referral requirements.

At TRH Business, we provide Charge Entry service as a part of the Revenue Cycle Management Services package or as a stand-alone service. We can start with Demographic / Charge Entry process directly after just a few calls to

understand the work flow to be followed, as we have a pre-defined set of domain specific rules in charge entry for different provider specialties and just we need to add the “Office / Payers Protocols” to them for each client, which cuts the room for errors and contributes to clean claims.

If we find an issue with the Encounter at the time of the charge entry, that super-bill is put on hold and a clarification is required from the Practice / provider medical office prior entering the charges. At TRH Business, Charge Entry Team’s goal is to have Clean Claims entered into EHR/PMS within 24 hours but no more than 48 hours from charge Batch receipt. The final charges Batches are audited by the Quality Control team and the Clean Claims are sent for submission. Weekly Charges Log with updated protocols if applicable, is shared with practice / provider office.