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How to Avoid Claim Denials

Medical Claims Denial appeals formThe best healthcare practices know that managing claims and avoiding unnecessary claim denials is a crucial part of the business. Errors, oversights, and delays in processing can cause more  than you might think. To have an immediate impact on your business make improvements in these three areas.

All claims must be legible. Even claims printed electronically can get messy, smudged, or blurred from printers and scanners which can create a huge problem for payers. Payers must be able to read and scan claims into their system immediately upon receipt for you to get paid quickly.

Make sure all claims are detailed and specific about the care received by the patient. It’s uncommon for claims missing facts such as the date of the accident, emergency or onset of the medical condition to be denied. It’s important to answer each and every question on a medical claims form.

File all claims in a timely manner. This can get complicated to manage because each insurance carrier operates under its own guidelines and payment schedule. Carriers will deny claims that are simply not received within their payment window stipulated. When you are working with a number of different insurance carriers, you can quickly see the benefit of working with a medical claims processor like Apex EDI.  

Apex EDI works with providers to carefully manage insurance claims and make sure all filing deadlines are met for multiple payers. This allows you to get paid fast and stay focused on providing excellent patient care. Contact us at Apex EDI for a free demonstration today.

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What Does a Medical Claims Processor Do?

Caring for the health of your patients is the most important part of your business. That is why millions in the healthcare industry rely on specialized professionals, like Apex EDI, to manage the complex interactions between healthcare providers and medical insurance companies. Allowing others to handle this responsibility for you lets you focus your attention where it should be, on the patient.

When a patient seeks medical care, behind the scenes Apex EDI manages the transaction between the provider and the insurance company. We obtain a record of medical services provided from the office, clinic, or hospital and we handle the responsibility of sending healthcare claims out to the patient’s insurance company.

Medical Claims Process can be complicated

The medical claims process is a complicated, yet a crucial component to making sure you get paid accurately and quickly. The knowledgeable staff at Apex EDI understands medical coding, billing terminology, compliance requirements, common errors and the best ways to work with a variety of insurance providers from HMOs, PPOs to Medicare and Medicaid.

We know that payers can deny or reject claims when errors are made. We want to work

with you to help make sure your patient receives the best care possible, receives the insurance coverage they are entitled to, and you get paid in full. There’s nothing more frustrating than dealing with financial payment discrepancies during a health care crisis.  

Working with a medical claims processor can have a positive impact on your healthcare practice and your financial bottom line. Contact Apex EDI to request a free demonstration today.

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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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Why Doctors Should Monitor Medical Claim Status

Doctor fees

Most doctors have experienced some medical claims headaches at some point in time. The routine monitoring of patients’ medical claim status can help you prevent potential problems or claim denials before they occur. The likelihood that you will ever receive a payment drops significantly if your claim is denied once.

You can save a lot of time by using an electronic medical billing software system. Electronic transactions and standardized reports make it much easier to ensure payments for health services are accurate. Automated computer billing rules can spot problematic claims before they are submitted.

Then, of course, no one likes to follow up on late payments, but if you delay you are much less likely to receive full payment for services rendered. Medical billing software can simplify the process of tracking receivables and monitor underpayments to ensure that you follow up quickly. It also ensures that you stay compliant with ICD-10 regulations.

A good software tool gives you the ability to spot problems at a glance. You will be able to catch errors, see the status of all claims and know when you need to follow up right away. We want to make this process easy for you and free up your office staff’s time to care for patients.

At Apex EDI our supportive, highly skilled staff is always ready to assist you. We want you to get paid on time for every patient’s medical claim. Contact us at Apex EDI to request a software demonstration today.

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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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