News & Events

Medical Billing Clearinghouse: Electronic Health Record Use Adopted by an Increasing Number of Practices

Physicians and healthcare providers are continuing to invest in the use of medical claims software systems. According to a survey conducted by the consulting firm Software Advice, they are doing so to increase efficiency for medical staff and for their patients. The survey found that 35 percent medical claims software users indicated that they are investing […]

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Posted in: Medical Billing Clearinghouse

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Medical Billing Clearinghouse: What Can I Gain by Using Billing Software? What Can I Lose If I Don’t Use It?

Most healthcare providers spend years learning how to build a successful medical practice and focus on providing top notch patient care. Yet, sometimes ignored, medical claims, is an extremely important component of your business. Billing challenges can slowly drain your financial outcomes and become a serious distraction for office staff. The business side of your […]

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Posted in: Medical Billing Clearinghouse

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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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Posted in: Medical Claims

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