News & Events

Medical Credentialing With Apex EDI

Medical credentialing is a complicated process that may take many hours or several days of your time to complete. Apex EDI has the experience to get you credentialed with the correct insurance payers quickly and inexpensively. Save your time and money by having an Apex EDI specialist complete your credentialing applications and submit them to payers.

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This will leave your team free to focus on patient care while Apex EDI deals with payers on your behalf. Our service is so cost effective, it can be recovered with the first few patient claims paid. We understand the process and can complete all applications, monitor your account, let you know when you need to re-credential and ensure 100% accuracy.   

You will be provided with your very own dedicated credentialing specialist for personalized service. Trained and experienced specialists are available by phone or E-mail, Monday through Friday, from 8 am – 5 pm. Your specialist will work with you to research status, add or remove providers, obtain your NPI, and consolidate applications or complete them one at a time.  

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On the other hand, if you turn away just one potential patient because you haven’t credentialed with their insurance company, you’ve lost business and profit. We have experience working with all major commercial, government, state and EFT payers. Whether you are credentialing with insurance payers for the first time or re-credentialing for the sixth, let us show you how to put more time and money in your pocket with a cost analysis.

It’s easy to get started with Apex EDI. Contact us to receive a personalized quote today.

Posted in: Apex EDI, Medical Credentialing

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Getting Tested for Sleep Apnea

Sleep apnea is a common health problem that is characterized by interruptions in your breathing cycle while sleeping. Lack of a restful night can lead to headaches, stress, chronic fatigue and can increase your risk for a variety of health issues including diabetes and high blood pressure. If you experience frequent sleep disruptions such as loud frequent snoring or pauses in breathing it’s important to see a healthcare provider for a sleep apnea test.

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The testing process is simple, painless and fast. It may take place overnight in your home or in a sleep lab facility depending on your health provider and insurance coverage. Most people don’t experience any discomfort during the test and fall asleep during the procedure. Adhesive sensors are placed on your body at the scalp, forehead, chin, chest, leg, and index finger to collect information from your brain, heart, lungs, and muscles. Bands may also be wrapped around your chest and stomach to measure your breathing. Data is gathered while you sleep.

Your doctor will review the information on your sleep patterns and work with you to develop the best treatment plan for your condition. There are lots of treatments for sleep apnea including special equipment and breathing machines that can help you to get a peaceful night’s sleep. The first step in a healthier life is getting tested.  

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Most insurance companies will pay for a medical sleep study ordered by a provider. At Apex EDI, we’ll make it easy for you to pay your sleep apnea claim. We know a good night’s sleep is vital to your overall health. If you are interested in finding out more about these type of claims then contact us at Apex EDI today!

Articles with this disclaimer may not represent the beliefs or core values of Apex EDI. The above is simply a summary taken from the industry’s general community to help readers stay up-to-date on what people are talking about.

Posted in: Sleep Apnea Claims

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ICD-10 Changes – Filing Your New Claims

ICD-10-CM is the diagnosis code set that replaced ICD-9-CM Volumes 1 and 2. ICD-10 is used to report diagnoses in all clinical settings. All providers, including physicians, health care clearinghouses, and payers must comply with ICD-10 to meet the Health Insurance Portability and Accountability Act (HIPAA) requirements.

ICD-10 codes went into effect on 10/1/15 for claims with a date of service on or after 10/1/15 and replaced an outdated code set that had been in effect for over 30 years. This update was essential to reflect advances in medicine, medical technology and knowledge. The greater detail available in the ICD-10 code set means that the code can provide more specific information about the patient diagnosis.

 

While many payers struggled to prepare for ICD-10, APEX EDI successfully tested ICD-10 claims with Medicare, Blue Cross Blue Shield, Medicaid, Worker’s Comp, and other payers. We also participated in numerous ICD-10 webinars and training sessions with providers and industry leaders in billing and paying services.

Apex EDI recognizes the change to ICD-10 as a significant shift for healthcare providers. Many providers have experienced disruptions in transactions being processed and receipt of payments. Physicians have been urged to set up a line of credit to mitigate any interruptions in cash flow.

Our systems were updated early in this change to transmit ICD-10 codes. Contact us today because we have a supportive, friendly staff available to simplify all phases of this change for you. We will answer questions, offer educational resources, test your claim files, and work with channel partners and payers to ensure you receive faster payment in compliance with current codes and regulations.

Articles with this disclaimer may not represent the beliefs or core values of Apex EDI. The above is simply a summary taken from the industry’s general community to help readers stay up-to-date on what people are talking about.

 

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A Typical Visit to the Dentist

Routine dental checkups are essential to maintaining the health of your teeth and gums. Most dentists recommend visiting at least twice a year, although sometimes more frequent visits are in order depending upon your specific needs and health history. If you are anxious about the appointment, here’s what you can expect during a preventative dental checkup.

A dentist, with the assistance of a hygienist, will evaluate the overall health of your teeth and gums. They will look for signs of tooth decay, gum and bone disease. They will also check for calcium deposits on your teeth, stains, sensitivity, discoloration and tartar build up.

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If you have fillings, wear dentures or braces, they may check for wear and proper fit. You will discuss adjustments, proper cleaning techniques and use of tools such as electric toothbrushes, fluoride, mouthwash or dental floss. A visit might also include counseling about your diet and tobacco use that can affect your oral health.  

 

Dental X-rays also allow the dentist and inside view of your mouth and bone structure. While they aren’t performed on every visit, your dentist may ask you to bite down on a film holder while they capture a variety of images; such as a bitewing for upper and lower crowns, a periapical for the entire tooth, an occlusal image of the upper teeth and lower jaw closure, a cone beam computerized tomography for a 3D view and panoramic view of the entire mouth.

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Finally, your dentist will discuss treatment options and recommend the best time to return for a follow up visit. Apex EDI will make it easy for you to pay for your preventative checkups, dental treatments and follow up exams. We will simplify the billing process and ensure your claim is paid quickly so you receive the best possible dental care.  

Contact us to learn more about Apex EDI!

Articles with this disclaimer may not represent the beliefs or core values of Apex EDI. The above is simply a summary taken from the industry’s general community to help readers stay up-to-date on what people are talking about.

 

Posted in: Apex EDI, Dental, Dental Claims, Uncategorized

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A Typical Visit to an Optometrist – What Your Claim Will Pay For

Even if you don’t need eyeglasses, it’s about time for a routine visit to an Optometrist. Our eyes play a very important role in our daily lives and a checkup can help prevent vision problems before they occur. If you’ve never had a vision exam, here’s what you can expect.

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First, your doctor will ask you to read letters of various sizes from a chart to test your close and long distance sight. You will also be tested for glaucoma with a device called a tonometer that blows a puff of air into your eye. Depending on your age and health, you may also be tested for your side or peripheral vision, 3D, and color vision.

Medicated eye drops may be used to make your pupils larger. This procedure allows the optometrist to get a clear view of the inside of your eyes to detect cataracts, muscle degeneration, and diseases that can impair your sight. It may be helpful to bring a pair of sunglasses along because your eyes may be sensitive to light for a few hours afterwards. Some practices provide these for you, but it is smart to bring your own just in case!

If you do wear eyeglasses or contacts, bring them along for the visit. It’s essential to check your vision regularly because it’s quite normal for our sight to change as we age. You will also want to bring information about your medical history and any prescriptions.

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Most medical insurance policies don’t cover routine eye exams, unless there is a diagnosis. Vision plans cover routine eye wellness exams. At Apex EDI, we’ll make it easy for you to pay for your exam. We’re aware of the specific billing differences between medical and vision claims. It’s important to have a plan of action that will meet your specific needs, utilize all of your benefits and protect the health of your eyes.   

Contact us today to find out more about Apex EDI and how we can help you and your practice.

Posted in: Apex EDI, Opthamology Claims

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