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Claims Processing: Could My Claims Be Returned by the Insurance Company? Why?

Claims can be returned for a variety of reasons. The most common cause for a rejected claim is missing or inaccurate information. For example, errors in patient data such as the date of birth, age, sex, address, or name will cause an immediate return. Then there is provider information and insurance identification numbers, which can […]

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Claims Processing: What is Claims Adjudication?

After a medical claim is submitted, the insurance company determines their financial responsibility for the payment to the provider. This process is referred to as claims adjudication. The insurance company can decide to pay the claim in full, deny the claim, or to reduce the amount paid to the provider. When an insurance company decides […]

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Medical Claims: What Does the Medical Claims Process Look Like?

The medical claims process begins when the patient goes to the healthcare provider for any service, from refilling a prescription to major surgery. The patient is responsible for paying the insurance deductible after the visit and providing insurance information to the healthcare provider. Typically, front office staff begin the claims process with a pre-registration form. […]

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

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 […]

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Optometry Claims: Why You Should Use Vision Billing Software

At Apex EDI, our goal is to help you create a better workflow within your clinic and simplify the billing process, so you can focus on patient care. The  has always been a source of frustration for office staff. Billing and coding errors can also be devastating to your practice. An integrated software system means […]

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