Data Entry and Clean Claims

By Stacey Fitzsimmons, Director 



As a billing company we estimate that at least 80% of the denials we see can be traced back to data entry/accuracy errors.  These errors occur on all types of insurance claims. 


Here are some examples:

  • Patient cannot be identified as insured
    • Name is not consistent with name on the membership card
    • Address is not accurate
    • Birth date is incorrect
    • Patients claim or membership number is wrong
  • Subscriber information is incorrect
    • Birth date is incorrect
    • Membership number is wrong
  • Insurance information
    • Insurance company entered is incorrect
    • Date of injury is incorrect
    • Patient not eligible for therapy
    • Patient co-pay is incorrect
  • Patient authorization information entered incorrect
    • Visits not actually authorized
    • Visits entered incorrect
  • Referring physician NPI is incorrect


Sending clean claims the first time has a definite impact on a company’s cash flow.  Some data entry errors are not caught right away and by the time they are there are other issues such as timely filing. 

Here are my recommendations to stop the vast amount of data entry errors.  Begin by making sure you have included “how to enter new patient data” as part of your front desk handbook.  Confirm that the person entering data has been trained by an expert and clearly understands how the information they enter gets transferred onto a HCFA 1500 (02-12).

Every time a denial is traced back to a data entry error, bring that denial back to the person who made the mistake so they can fix it.  This skill cannot be improved if the person entering the data does not know what mistakes they are making.  Sometimes it is faster and easier for the biller to just fix the error themselves but that does not help move the data entry person to a new level. 

It is important for management to keep tabs on errors and use it as a tool for measuring performance.  Standards and objectives should be built into the training program.  Getting paid right the first time is essential to any practice.  There is a lot of information needed to process a new patient and enter into the billing system - data entry is key to a healthy revenue stream. 

For more information on front desk training including entering data into your billing system give us a call at 508-422-0233.

Stacey Fitzsimmons, Director
Account Matters
A full service physical therapy billing company