Claims Submission
Claims Submission

Clearinghouse Integration

Electronic Claims Submission

Paper Claims

Hybrid Submissions
Ensure timely reimbursement and smoother revenue cycles with Emerger RCM’s Claims Submission service. We expertly package, validate, and submit claims across payer channels reducing errors and accelerating payments for your practice.
Electronic Claims Submission

Our electronic claims submission service leverages secure clearinghouses and payer portals to submit claims efficiently. We format data according to each payer’s specific requirements (ANSI 837, CMS-1500, UB-04), ensuring all necessary fields are complete. Real-time validation catches issues like missing modifiers or improper formats before submission.


Transactions are monitored with acknowledgement tracking for acceptances or rejections, enabling immediate correction if needed. This proactive approach minimizes denial potential and supports faster reimbursement cycles.
Paper Claims & Hybrid Submissions
For payers requiring non-digital submission or mixed modes, we prepare professional printed claims, with precise form layouts and cover letters. Our team ensures required documentation (EOBs, attachments) is included and that forms are scanned or faxed based on payer preferences. Hybrid workflows where some elements are electronic and others paper are managed seamlessly. All claim statuses are tracked centrally, ensuring visibility and avoiding lost or delayed submissions.
Contact us today to learn more about our team
We would be happy to answer any questions you may have or provide you with additional information about our services.
Clearinghouse Integration
Connects with top clearinghouses for streamlined electronic claim transmission.
Payer-Specific Formatting
Custom configurators ensure each claim meets unique payer requirements.
Real-Time Error Checking
Instant pre-submission validation flags errors for immediate correction.
Batch & Individual Submission
Supports bulk claims upload and one-off submissions as needed.
Submission Acknowledgement Tracking
Monitors EDI 999/277 acknowledgements to confirm claim acceptance or flag rejections.
Hybrid Mode Management
Coordinates paper, fax, and electronic submissions under one system.
Emerger’s system allows for scheduled, automated batch transmissions of claims at regular intervals daily, multiple times per day, or as configured. Claims are batched by payer or specialty, ensuring efficient throughput and minimal manual intervention. Batching reduces processing fees and promotes consistency.
Scheduled submissions eliminate human error and free staff from manual uploads. If a batch fails, alerts initiate corrective workflows immediately. You’ll receive batch status reports with detail on volume, submission time, and acknowledgements supporting operational transparency and optimization.
Every insurer has unique claim formatting rules, deadlines, and modifiers. Our custom rule engine stores payer-specific logic such as valid CPT code pairs, provider eligibility, and submitter taxonomy. It validates each claim against these rules before submission.
Rules are updated frequently as payer policies shift, so we ensure ongoing compliance. Claims that fail compliance are halted, logs generated, and corrections requested. This specialized system reduces bounce rates, improves first-pass acceptance, and significantly decreases rework and administrative costs.
Many claims require attachments like operative reports, clinical notes, or authorizations to support billing. Emerger manages digital attachments through payer portals or paper workflows. Every document is quality checked and matched to claim reference numbers.
For paper attachments, we prepare PDFs or ensure fax delivery, and confirm receipt. Our team tracks whether attachments are accepted, pending, or rejected and takes corrective measures. This level of diligence improves claim completeness and minimizes delays caused by missing documentation critical for high-complexity or manual review cases.
After submission, we monitor electronic acknowledgements (EDI 999) and claim status notifications (EDI 277). Our system flags any rejected claims immediately, categorizes rejection reasons (e.g., invalid subscriber ID or format error), and initiates automated or manual remediation.
Notifications are posted in your dashboard, and tasks are created for resolution. This visibility enables fast action, reduces submission gaps, and safeguards claim integrity. Practices benefit from informed oversight knowing exactly which claims need attention and why.
Our submission module includes a robust analytics dashboard to track submission KPIs volume, acceptance/rejection rates, lag times, and cost impact. Reports offer drill-down views by payer, provider, or period. Management can assess trends, identify payer-specific issues, and measure improvements over time.
These insights are shared in regular updates, offering recommendations to optimize workflows, adjust scheduling, or refine payer configuration. By pairing data with action, your practice gains operational efficiency, improved financial performance, and a framework for continuous improvement.