CLAIMS SUBMISSION SERVICES

Medical Claims Submission Services That Do More Than Click Submit

SkyLine MB reviews each charge, scrubs the claim, submits it electronically and checks every acknowledgment — so rejections are fixed while there’s still time to fix them.

FREE CONSULTATION

Get claims submission support

Tell us about your claim volume, payers and billing system. A claims specialist will contact you to discuss scope — no obligation.

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Scrubbed

Before submission

999 & 277CA

Acknowledgments checked

Monthly

Acceptance review

No lock-in

Flexible agreement

Physician entering charge details on a keyboard before a claim is scrubbed and submitted

Every batch checked after submission

OVERVIEW

What Are Medical Claims Submission Services?

Claims submission services prepare clean claims from your charges, send them to payers electronically and confirm the payer actually received and accepted them for processing.

A claim can be rejected even when codes are correct — a subscriber ID, NPI or address mismatch is enough. SkyLine MB reviews the claim before release, reads the 999 and 277CA acknowledgments after submission and corrects rejections quickly.

Who it's for

Practices with rejections, backlogs or slow claim release

What's included

Charge review, scrubbing, submission, rejection fixes

How it's priced

Per claim, monthly, or bundled with billing

Turnaround

Targeted within 24–48 hours of complete charge information

THE CHALLENGE

Why Claims Get Rejected Before a Payer Even Reviews Them

Clearinghouse and payer front-end edits reject claims for data problems that have nothing to do with coding.

999 / 277CA

The acknowledgments that confirm a claim batch passed validation and was accepted by the payer. — X12

12 months

Medicare generally requires claims to be filed within 12 months of the date of service. — CMS

Subscriber data mismatches

Member IDs, names or dates of birth that don’t match payer records.

Provider data errors

NPI, taxonomy or address details that don’t match enrollment.

Unchecked acknowledgments

Rejected claims sit unnoticed in the clearinghouse.

Coding edit failures

Invalid code pairs and missing modifiers stop claims.

Corrected claim rules

Frequency codes and original claim numbers used incorrectly.

Timely filing

Rejected claims aren’t fixed before the filing limit.

Clearinghouse rejections and payer denials are different problems. We check both — and fix rejections before they turn into lost claims.

WHAT'S INCLUDED

Claims Submission Services We Provide

Scope submission around your volume and systems. We agree how charges reach us and how often batches are sent.

Charge Review

Charges checked for codes, units, modifiers and dates.

Learn more →

Claim Scrubbing

Payer, NCCI and clearinghouse edits checked before release.

Insurance Data Checks

Subscriber and payer details matched to the claim.

Learn more →

Electronic Submission

Claims sent in standard 837 format through the clearinghouse.

Acknowledgment Review

999 and 277CA responses read for every batch.

Rejection Correction

Rejected claims fixed and resubmitted promptly.

Corrected Claims

Replacement and void claims filed with the right frequency code.

Timely Filing Checks

Filing limits checked before claims age out.

HOW IT WORKS

Our Claims Submission Process, Step by Step

Six stages from charge to accepted claim. During onboarding we agree how charges reach us, submission frequency and clearinghouse access.

STEP 01

Charge received

Charges and documentation received from your EHR.

STEP 02

Claim review

Codes, modifiers, units and insurance data checked.

STEP 03

Scrubbing

Payer and clearinghouse edits applied before release.

STEP 04

Submission

Claims sent electronically, targeted within 24–48 hours.

STEP 05

Acknowledgments

999 and 277CA responses checked for every batch.

STEP 06

Fix & resubmit

Rejections corrected and resubmitted within filing limits.

IN-HOUSE VS. OUTSOURCED

Outsourced Claims Submission vs. In-House Billing

What it takes to get every claim accepted for processing.

Compare staffing, scope and oversight before choosing a model
What mattersIn-houseSkyLine MB (outsourced)
Staff timeClaims sent between other tasksSubmission handled on an agreed schedule
Pre-release reviewBasic system editsCharge, data and payer edits reviewed
AcknowledgmentsOften not checked999 and 277CA read for every batch
RejectionsFound weeks laterCorrected and resubmitted promptly
Corrected claimsFrequency codes guessedReplacement rules followed by payer
Timely filingMissed on old rejectionsFiling limits checked before resubmission
ReportingClaim counts onlyAcceptance and rejection reporting
Security responsibilitiesPractice safeguards and accessShared responsibilities, a BAA and agreed access

Submission is one part of the claim. For follow-up after the payer responds, see our medical claims processing services.

PRICING

How Much Do Claims Submission Services Cost?

Submission is priced per claim, as a monthly fee or as part of a billing engagement.

Per claim

A fee for each claim prepared and submitted. Confirm whether rejection fixes are included.

Rate depends on claim type

Best for variable volume

Monthly fee

A fixed monthly price for an agreed claim volume.

Varies by volume

Best for steady volume

Bundled with billing

Submission included in a full billing engagement.

Quoted with your billing scope

Best for practices outsourcing billing

HOW SKYLINE MB PRICES

One clear rate, quoted after a claims review

Your quote reflects claim volume, payers, specialty and how charges reach us. We confirm scope and rejection handling in writing before you start.

TRANSPARENT REPORTING

The Claims Submission KPIs We Report Every Month

Monthly reporting shows how cleanly claims go out. We agree definitions during onboarding.

Clean claim rate

Acceptance

Initial claims accepted without correction ÷ initial claims submitted.

Rejection rate

Front-end edits

Claims rejected by the clearinghouse or payer ÷ claims submitted.

Submission lag

Days to submit

Average days from complete charge information to submission.

Rejection turnaround

Days to fix

Average days from rejection to accepted resubmission.

Top rejection reasons

Data quality

Rejections grouped by cause, such as subscriber or provider data.

Timely filing risk

Aging

Unaccepted claims nearing a payer’s filing limit.

Acceptance confirms a claim entered processing; it does not guarantee payment. Definitions are agreed during onboarding.

EHR & PM SYSTEMS

Works Inside Your Current EHR

We assess your current EHR and practice-management workflow first, then agree access and handoffs with your team.

Using another system? Tell us which platform you use so we can confirm compatibility and access requirements.

TECHNOLOGY

Automated Claim Scrubbing With Human Review

Scrubbers catch invalid codes, missing data and payer edits in seconds. But some rejections need a person — checking enrollment, subscriber records or corrected-claim rules.

COMPLIANCE & SECURITY

HIPAA-Compliant Claims Submission

Claims carry PHI in standard HIPAA transactions. We sign a Business Associate Agreement and use role-based access to your billing system and clearinghouse.

FREE CLAIMS REVIEW

Not sure why claims keep getting rejected?

We review recent rejections and acknowledgments, group them by cause and show you which data or process fixes would stop them.

What happens next: send your practice details, speak with a specialist, then agree a secure way to share anything needed for the review. Do not send patient records through this enquiry form.

CLIENT STORIES

What Practices Say About SkyLine MB

Independent practices, specialty groups and clinics trust us with the work that keeps revenue moving.

FAQ

Frequently Asked Questions About Claims Submission Services

Straight answers to what practices ask before choosing a billing partner.

Still have a question?

Talk to a billing specialist — no sales pressure.

Our claims submission services cover claim preparation, review of required billing information, electronic submission, acknowledgment tracking, rejection correction, and coordination with billing personnel when additional payer follow-up is needed.

Yes. A claim can fail because of incorrect patient information, missing provider identifiers, payer routing errors, or other administrative requirements even when the procedure and diagnosis codes themselves are valid.

It means the claim passed the clearinghouse’s applicable acceptance checks. It does not necessarily establish that the receiving payer accepted the claim for adjudication or will approve payment.

A 999 reports transaction-level implementation acknowledgment information. A 277CA provides business-level claim acknowledgment information, including whether applicable claims were accepted or rejected for processing.

Many rejected claims can be corrected and resubmitted. The required action depends on the reason for rejection, payer rules, available documentation, and timely filing requirements.

Our billing team can support corrected-claim workflows where required. We review the original claim history and applicable payer instructions before determining the submission method.

Good claim preparation can help prevent certain errors that contribute to rejected or denied claims. However, coverage, medical necessity, and other payer determinations may still result in denials even when the original submission is accurate.

Our shared medical billing operation includes secondary claim submission support. We review the available primary payer adjudication information and applicable coordination-of-benefits requirements.

Yes, subject to the system’s available functionality and authorized access. Our shared billing team has experience with several commonly used practice management and billing platforms.

Turnaround depends on when complete charge and documentation information is available, claim complexity, system requirements, and unresolved errors. We establish the processing expectations for the agreed service arrangement.