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Archive for Medical Claims

Medical Claims: Will Medical Claims Software Help My Practice? What Should I Look For?

Concentrated female doctor using computer at desk in medical office

Implementing a medical claims software is an easy way to see an immediate increase in revenue for your health care practice with a minimal investment. The software allows your staff to focus their time on what’s really important, the care of patients, rather than tracking and submitting medical claims. There are a number of features to look for in a good medical claims software.

First, you will want to make sure the software partner you select offers the best customer support possible. Look for a company that can offer the assistance of a well-trained, knowledgeable support staff to address any technology questions your staff may have. At Apex EDI, we are committed to providing the fastest, most personal, and most capable customer service and technical support in the electronic claims processing industry.

Then you will want to be certain the software is equipped to keep up with ongoing changes in the healthcare industry. The system must have the highest level of data security to remain in compliance with patient privacy regulations. You will also want superior coding and reporting functions that will increase the efficiency of your practice.

The American Medical Association reported that the average practice can cut medical claim submission costs by up to 55% by simply making the transition to an automated medical claims software. At Apex EDI, we want to help you reduce your costs and increase the accuracy of your claim submissions. Our medical claims software offers the most complete range of features in the industry. Contact us to watch a free demonstration of our software today.

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Medical Claims: What Can Medical Claims Software Do for My Clinic?

Computer system health or auditing - Stethoscope over a computer keyboard toned in blue

There are many benefits of having an up-to-date medical claims software tool. A good claims software system will help ensure you receive fast reimbursement for all the services you provide to your patients, stay compliant with current health regulations, save time and reduce costs for your office.

You will have instant access to all billing data and be able to monitor the performance of your practice using real-time financial information and analytics. The operational efficiency of your office can improve greatly by relying on a highly trained, supportive medical claims software team to respond to any questions you have about patient billing issues.

Electronic patient medical billing ensures your patient healthcare data is stored securely and in compliance with HIPPA (Health Insurance Portability and Accountability Act) regulations. This reduces the risk of a legal complaint for your office. You can also feel confident knowing you won’t have to shoulder the responsibility of any changes to billing regulations, unforeseen technical difficulties or data storage issues.

You have enough to focus on with patient registration, scheduling and providing quality health care for your patients. Let a trained and qualified medical claims software team take care of routine medical billing, billing related compliance, and the resolution of billing issues for you.

There is no easier way to have a direct impact on your clinic’s financial performance than a software tool that will ensure that you are paid promptly for the patient care you provide. Contact Apex EDI to request more information. We would love to provide you a free demonstration of our software today.

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Medical Claims: Patients Can Claim Medical Expenses on Taxes

Series for United States Tax season, with 1040 forms, etc.

When patients have unexpected medical expenses, it’s nice to know that there are many claims that can be deducted from income taxes with proper documentation. Preventive care, treatment, surgeries, dental, vision care, medications, and health related appliances like glasses or false teeth can all qualify under IRS rules as medical expenditures.

Medical expenses that the patient is reimburse for by the insurance company or employer cannot be deducted from income taxes. Non-prescription drugs and other general health related fees such as health club dues, vitamins or diet foods do not qualify for exemption.

To utilize these tax rules, the patient must be able to itemize tax deductions. This requires billing receipts and documentation of all medical claims incurred by the patient for health care services. Travel expenses such as mileage to and from the doctor’s office, taxi fares, and parking fees can also qualify for deductions with accurate records.

The patient must also be able to show these medical deductions are greater than the standard tax deduction allowed and that they exceed 10% of their adjusted gross income for the year. While it’s a lot of information to keep up with, the Apex EDI software helps organize the details they will need for you.

We know you want to provide exceptional patient service and be prepared to respond to tax time requests. Let Apex EDI simplify the process of filing medical expenses and claims information for you. You will be able to retrieve all of the information your patients need quickly with ease.

Contact Apex EDI to request a free demonstration of our software.

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Medical Claims: How Long You Should Keep Medical Claims and Bills

Keeping medical claims documents and billing information can be useful for many reasons. They help you establish a health history for yourself or loved one, ensure you are receiving the medical benefits you are entitled to, and demonstrate that you’ve met an annual insurance deductibleYoung woman physician with stethoscope prescribing treatment and qualifications for income tax deductions.

You will want easy access to records showing the services provided, the payment amounts billed for services, the amount covered by insurance or Medicare, and the amount you paid the provider. People often wonder how long they should keep this information. If you have ongoing health care needs, paperwork can pile up very quickly.

Generally, if you are in good health and seeking treatment for normal preventative health care and maintenance you should keep medical claims and billing information for one year. At the end of the year, if you qualify for a medical tax deduction then file this information with your income taxes. Keep your tax file on hand for seven years.

If you are facing a serious health condition or chronic illness, it is important to keep medical claims and billing information close by for at least one year. At the end of the year, if you have filed for a tax deduction store the information with your income taxes and cross reference it in a medical file. In the medical file, you will be able to match services with billing receipts and retain the information until the health condition has subsided.

In the unfortunate event that the patient has passed away, the medical services and billing information may be needed for the execution of a will. The information will be available to wrap up the legal process and settle the estate as quickly as possible for the entire family.

While a file cabinet may do, a more effective and efficient way to store medical records is to keep them electronically. This will keep the information you need safe and secure from water damage, disorganization or loss. At Apex EDI we provide the service and software to organize your medical claims and billing information.

Contact us to request a free demonstration of our software today!

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Medical Claims: Medical Claims Can Be Appealed

Medical appeals form
Processing medical claims can get confusing, especially when someone files an appeal. According to the Department of Labor (DOL) Employee Benefits Security Administration (EBSA) there are four determinations during the medical claims process that can be appealed by anyone.

An urgent care claim is one that would substantially impact the life of the claimant or result in severe chronic pain unmanageable without treatment. Pre-service claims are those that require precertification by a healthcare provider before services are rendered. Post-service claims are those payments due after health services are rendered. Disability claims are those that create a medically related barrier to the claimant’s return to work.

All claims and appeals must be responded to as soon as reasonably possible. Administrators only have up to 30 days to respond, with the possibility of a one-time 15 day extension. Any requests for additional information or clarification must be detailed and specific.

The claimant has up to 45 days to respond. He or she is also entitled to any rules, protocols or medical basis for the determination free of charge. This exchange can make the burden of claims processing expensive and quite time consuming.

We want to take care of this headache for you, so you can focus on the care of your patients. The APEX EDI medical claim filing software simplifies the claim payment process. Our award winning team understands the laws related to claims processing, protecting health information and they want to save you time and money.

Contact APEX EDI for a demonstration of our software today!

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