To avoid claims rejections and ensure payment, healthcare providers should submit claims with accurate and complete information like valid diagnosis codes. They should also follow requirements in contracts specifying timeframes for payers to process clean claims. Providing proper documentation can help get claims paid within the required period instead of being delayed or denied.

1. Part I: Avoid claims rejections
A payer may delay or deny payment because of inaccurate or missing information in a submitted
claim. Many contracts require payment within a specified period of time, for example, 30 days
from submission of a "clean claim." How can healthcare service providers avoid claims
rejections?
Part II: Ensure payment
The Medicare intermediary has returned a claim to a hospital because of an invalid diagnosis
code (OCE
Solution
1 & 2