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Whenever possible, WPS encourages health care providers to file
their claims electronically. Electronic filers receive these benefits:
- Faster claims processing. Providers who file claims electronically
receive payment sooner than if they filed the same claim on paper.
| Average processing time statistics for WPS
Commercial claims: |
| |
Electronic Claim |
Paper Claim |
| HCFA-1500 |
5.2 days |
13.3 days |
| UB-92 |
6.5 days |
12.29 days |
- Reduction of payment errors and data entry errors. As a result
of WPS' pre-edits for EDI, claims which pass to the processing
system pend less frequently. This means less potential for processing
errors.
- Immediate verification of claims received. All of WPS' verification
reports provide vital feedback at each stage of the EDI processing
cycle. This feedback is not present with paper claim submission.
After transmitting your claims to WPS, you receive a verification
notice via e-mail indicating the number of claims and dollar amount
we received. Also, an "Error Report" will be available
the business day following your transmission. This report indicates
whether any claims were submitted with errors and what changes
need to be made for claims to be accepted for processing. These
claims can be corrected and resubmitted electronically.
- EDI program edits minimize the impact of data entry errors at
your office by requiring certain information be entered on your
claims.
- The relative ease of use of EDI and the support available from the contractor to assist them in beginning use of EDI transaction.
- Lower administrative, postage and handling costs.
- Availability of free software.
- Availability of batch claims status inquiries.
- The payment floor for Medicare Part B IL, MI, MN, WI claims is 14 days for electronic versus 30 for paper.
- Faster claims processing. Providers who file claims electronically receive payment sooner than if they filed the same claim on paper.
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