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Medical Billing Software: How to Close the Loopholes in Your Medical Claims Billing

Medical Billing Software: How to Close the Loopholes in Your Medical Claims Billing

Recent findings have proven that medical bills are among the leading causes of bankruptcy. But the high costs of staying healthy aren’t just tough for your patients – they can also be a financial strain on your practice. 

In this post, we’re outlining the best ways to close the loopholes in your medical claims billing by pointing out common errors and the best ways to prevent them by using electronic billing and tracking software, talking to staff, and more.

You can’t afford to skip this article. 

Tip 1: Stop Pushing Paper

It’s easy to make mistakes in your medical claims billing process when you’re doing things the old-fashioned way. Software can not only help to save you time and streamline the efficiency of your billing process. It can also help you to catch serious, costly errors. 

This automated process should begin with the scheduling of your appointments.  Look for software that sends out automated email reminders and other notifications when it comes to both the booking and billing process. 

You should also use digital forms and record keeping strategies to make sure that nothing slips through the cracks. Plus, you won’t have to waste your customers’ time asking them to fill out a form again if a hard copy gets lost. 

Your software should also be able to check your procedure codes, keep records of the services your practice provided that day. Also accurately keep track of all the costs to both patient and practice. 

Tip 2: Make Sure You’re Always Keeping Up With Regulations

Even if you’ve only been in practice for a short while, you’ve likely already experienced several changes to the medical claims billing process. 

These claims and the regulations surrounding them are changing all the time. To avoid problems and errors that cost you both time and money to correct, make sure you’re always keeping up with the latest regulatory news and standards. 

How can you accomplish this? Make sure that you’re always implementing new staff training programs.

Also, are you using the right technology and software to alert you when regulations have once again changed? Are you keeping in touch with other professionals in your industry?

Tip 3: Don’t Let EOBs Fall Through The Cracks

EOBs, or Explanations of Benefits, can be a lot to unpack. We get it: there’s a lot to handle and keep track of when it comes to your medical claims billing.

Still, just because a claim has been denied doesn’t mean it’s OK to move onto something else. 

Make sure that you’ve created a system to keep track of denied claims that works for you and your practice. Also, take the time to ensure you’ve followed up on any claims that come with EOBs. Always follow up!

Talk to your team about their ideas to improve this part of the medical billing process.

Then create a firm schedule and plan to implement their ideas.

Tip 4: Watch Out For Improper Coding and Payments For Services

Look, mistakes can happen when it comes to medical claims billing. But, they can also be very costly.

Always run audits as often as you can, and make sure that you’re not over-billing for the services your practice provides – or worse, under-billing. Also, scrutinize the bills you get for ordering medical equipment. Especially look at shipments of medical supplies. Vendors can make mistakes in billing, too. 

Especially if you’re on an automated order system, this is crucial to prevent a serious hit to your budget. Make sure too, that you’re accurately billing for each part of a service. Use separate codes for each service provided. Not just one overarching code. 

Anything you can do to cut down on errors is going to save you money in the billing process. Not to mention, prevent a lot of headaches for both your patients and your practice. 

Tip 5: Make Sure You’re Managing Your Staff Effectively

When it comes to properly handling your billing methods, communication is key. That should start with intraoffice correspondence. It should also cover a thorough examination of how your employees are communicating with your patients. 

To get a feel for how errors are happening, and the most common problems your staff are facing, start by talking to and surveying your medical billing staff. 

What are the parts of the billing process that are causing them the most headaches? What are their most frequent errors? What do they wish was easier to handle when it comes to the billing process? What are their ideas for improvement? 

Remember that when it comes to medical billing, one small error can often lead to several more. The cost to your practice can increase exponentially. 

Ask yourself and your staff how you can be more clear when it comes to the billing process. How can you reduce the number of claim denials you’re seeing? Are you being clear with your billing policies? Is your staff clearly communicating those policies to your patients?

Examine what your follow-up process looks like. Ask how you can shorten the timeline of the process. Do this by tracking the claims across the entire billing cycle. Also work with the healthcare payers to make sure that claims are quickly filled out and filed.

You’ve Got The Information You Need To End Medical Claims Billing Errors

In recent years, the margin of error when it comes to medical bills has been as high as 70%. No wonder so many patients are challenging their medical bills.

Not only does this affect the efficiency of your office and practice. It also makes you appear disorganized and even untrustworthy in the eyes of your patients.

It’s time to put a stop to costly, time-eating errors in your billing process.

Want more information about how you can prevent and correct errors in your medical billing process? What about the types of software you can use to make it happen? Get in touch with us today. Check out our website to learn more.

Make this the year you reduce your margin of error on medical billing. Make it the year that your patients are happier than ever.  

Posted in: Medical Billing Software

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Medical Billing Software: How Do I Spot Medical Billing Errors?

Medical claims can be difficult to understand. When a patient has a serious health condition, there may be several provider, specialists, and medical facilities involved in their care. Bills can be loaded with abbreviations and medical terms that the average patient may not be familiar with. It’s important to arm yourself with the confidence to question a potential billing error.  

Medical bill from the hospital, concept of rising medical cost, selective focus.  All data on the bill and form design are fictional, created specially for this concept.

The first step in questioning a medical claim received for services is to make sure you review each detailed charge. If you receive a summarized statement, you may need to request an itemized bill. Read through the dates of service, provider, and insurance information to confirm its accuracy.


Check for obvious duplications. If a service is charged multiple time, it is most likely a mistake. Also check for omitted or missing information. For example, you may receive a statement summary that does not indicate past payments made. It will not hurt to be certain all previous payments are accounted for before submitting your final payment.

Errors in coding services received in the bill can be more difficult to spot. If your bill contains any charges that seem suspicious, mark them so you can ask your provider about them later. It’s not uncommon for billing specialists to miscode a charge.  

Take your time with the call the provider and ask any questions you have about the statement. Your healthcare provider wants to work with you to make sure you are happy with the overall care you receive. Apex EDI helps doctors focus on healing by supporting them with the best technology for medical claims.

Contact Apex EDI to watch a free demonstration of our software today.

Posted in: Medical Billing Software

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Medical Billing Clearinghouse: What You Should Know Before Challenging a Medical Bill

Many patients have higher deductibles with their medical plans today than they did in the past.  This means they have an interest in paying closer attention to the medical claims they receive.  While many healthcare providers provide payment options intended to help the patient, before challenging a medical bill there are some key issues to keep in mind.

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First you will want to ensure that you clearly understand all the charges. This means you may need to ask for a detailed bill, showing every service performed by your provider. The line item bill should also clearly indicate others the provider relied on for services such as lab results.

When you don’t understand a charge, it’s time to reach out to the provider. Start with a phone conversation to see if the office staff or the doctor can explain all services indicated on the statement. In many cases, this conversation can resolve concerns quickly.

In more complex situations, it may be necessary to follow up with other specialists either by phone or in writing. In that case, make sure you have thorough notes about your initial conversation. Be sure to note the name of the person you speak with, their position, the date and time of each call.

While you should pay close attention to your financial ability to pay for the care you have received, you will want to arm yourself with clear factual information prior to disputing a bill. Most healthcare providers want to provide quality of patient care at a competitive price.

Apex EDI works with healthcare providers and insurance payers to manage medical claims efforts. Contact Apex EDI to watch a free demonstration of our medical billing software today.

Posted in: Medical Billing Clearinghouse

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

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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 greater amounts in their systems than in previous years.

One major reason is the desire for mobile access to patient information. Medical billing software partners are able to keep up with technology and provide patient portals for prescribing medication, managing lab results, and communication. While many still access data from a desktop computer, it is possible to access information from laptops, tablets, smartphones, and other portable devices.

In addition to the improved access to patient information, the medical records are more easily read. Legible patient data is a simple way to prevent common errors in claims submissions. Even a misspelled patient name can cause a claim to be rejected, costing several weeks or months to make the correction. This means you receive payments from the insurance companies faster.   

Apex EDI is the fastest growing electronic medical claims partner in the healthcare industry. Our software solution is unique because it will work with virtually any practice management software. We offer superior customer support and the most complete range of features and capabilities in the technology. Interested? Well we have the perfect thing for you! Contact us today to watch a free demonstration of our medical billing software.

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?

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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 healthcare practice can be improved substantially with the implementation of a medical claims software. Working with a billing partner allows you to remain focused on patient care, while they handle the burden of worrying about insurance companies rules and constantly changing coding standards. It’s a cost effective way to ensure your claims are paid in a timely manner without the hassle.

The addition of a highly trained customer support team through a medical billing partner also saves money that you would spend on the ongoing education of your staff. The healthcare industry as a whole is changing. You’ll gain the security of knowing you can rely on an experienced, trusted team of representatives to ensure your billing practices are current.   

Even the smallest mistake on a claim submitted can cause an insurance company to reject the claim. Your practice loses time and productivity while your staff works to correct, resubmit, and wait for claims to be accepted by the insurance payer. This process can take several months before you receive payment.

Apex EDI wants to help you remain current with the industry’s easiest and most cost-effective medical billing solution. Contact Apex EDI to watch a free demonstration of our billing software today.

Posted in: Medical Billing Clearinghouse

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