Capture membership details at registration
Record the NHIA number and check that it is valid when the patient registers. A wrong or missing number at the start follows the patient through the whole visit and ends up on a claim that cannot be paid.
Use the correct tariff for every service
Claims are priced against the NHIA G-DRG tariffs and medicines list. Pricing by hand invites mistakes. Keep the tariffs in one place so every service and drug is priced the same way each time.
Record a proper diagnosis
Every claim needs a clear diagnosis that matches the services and medicines billed. Using standard ICD-10 codes keeps diagnoses consistent and makes it easier to defend a claim.
Vet claims before you submit
Check each claim for missing information, mismatched dates and services that do not fit the diagnosis. Fixing a claim while the patient record is fresh is far easier than correcting it weeks later.
Submit in batches and on time
Group claims into batches and submit within your period. Late claims are a common reason for lost income, so do not let them pile up.
Track every rejection and its reason
Keep a record of each rejected claim, the reason given and whether it was corrected and resubmitted. Patterns show you what to fix: if the same reason keeps appearing, the problem is upstream.