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4 Tips for Efficient Claim Submissions

Providers can help avoid claim denials and billing errors by following a few tips for accurate billing and timely claims processing.

Tip #1: Understand Contractual Filing Limits and Key Processes

Commonwealth Care Alliance Massachusetts and CCA Health Rhode Island accept claims by either Electronic Data Interchange (EDI) or industry-standard paper claims (UB04). Claim turnaround timelines are based on the claim receipt date. The receipt date is the day that CCA receives the claim.

Tip #2: Minimize Coding Errors
Be sure to double-check claims before submitting them. Pay particular attention to these common errors and validate all before submitting a claim.

Tip #3: Follow Billing Best Practices
Billing best practices ensure that claims are accurate and can be processed efficiently. Be sure that all of the following are included and accurate:

Tip #4: Sharing Provider data with CCA
CCA requires the most recent provider data.  Providers should follow these best practices to ensure claims are processed in a timely manner.

There are options for sending a monthly provider roster to CCA’s Provider Data Management team to add a new provider, terminate an existing provider, or update demographic data for your group or existing individual provider.