The Importance of Proper Handling and Management of 835 Files in Healthcare

The healthcare industry has been experiencing rapid changes in recent years, and one of the most significant changes has been the implementation of electronic health records (EHRs) for patient data management. With the move towards digitization, healthcare providers now have access to electronic 835 files, which are used to manage insurance claims and remittances. These files contain a wealth of valuable information that healthcare providers must manage properly to ensure that they receive prompt and accurate reimbursements. In this article, we will look at the importance of proper handling and management of 835 files in healthcare.

What are 835 files?

Electronic 835 files are payment and remittance advice documents that healthcare providers receive from insurance companies to explain payments and adjustments for insurance claims. The files contain comprehensive payment information, such as the amount paid by the insurance company, the date of payment, and the reason why the claim was partially paid or denied. The 835 files are also a valuable tool for healthcare providers to reconcile their accounts and manage their cash flow.

The Consequences of Mishandling 835 files

Mishandling 835 files can have disastrous consequences for healthcare providers. When the files are not handled properly, healthcare providers may miss payments from insurance companies, lose revenue, and face penalties for non-compliance with industry regulations. Inaccuracies in 835 files can also have a significant impact on the accuracy of medical billing records and can lead to costly legal disputes.

Best Practices for Proper Handling and Management of 835 Files

To avoid the negative consequences of mishandling 835 files, healthcare providers must develop best practices for the proper handling and management of their electronic payment and remittance advice documents. The following practices can help healthcare providers manage their 835 files effectively:

1. Regular Audits of 835 files

Healthcare providers must conduct regular audits of their 835 files to ensure they are accurate, complete, and up-to-date. Regular audits can help identify errors, omissions, and discrepancies, which can be corrected promptly before they cause any problems.

2. Use of Electronic Health Record (EHR) Systems

Using an electronic health record (EHR) system can help healthcare providers manage their 835 files more efficiently. An EHR system allows healthcare providers to automate the process of receiving and reconciling remittance advice documents, reducing the chances of human error.

3. Proper Documentation of 835 Files

Healthcare providers must ensure that their 835 files are appropriately documented, including all relevant information such as the patient’s name, date of service, and claim amount.

4. Staff Training and Education

Lastly, healthcare providers must invest in staff training and education to ensure that their employees know and understand how to handle 835 files properly. Healthcare providers need to ensure that their staff is aware of compliance requirements and that they follow best practices in managing 835 files.

Conclusion

The proper handling and management of 835 files are critical for healthcare providers. These electronic payment and remittance advice documents contain valuable information that healthcare providers must manage properly to ensure accurate and timely reimbursements. Healthcare providers must establish best practices, conduct regular audits, and invest in staff training and education to safeguard their financial health and avoid costly penalties for non-compliance with industry regulations. By managing their 835 files appropriately, healthcare providers can improve their financial health, increase their revenue, and provide better patient care.