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Medical Claims Processing: How Are Medical Claims Processed?

Once medical services have been administered to a patient, payment needs to be requested from insurance through appropriate channels. These requests for payment are known as medical claims, and to the lay person, filing them may seem rather complicated. We’re hoping to demystify this process by breaking down the way medical claims are filed and […]

Claims Processing: Optometry vs. Ophthalmology

Trusting a doctor with eye care is an important health care decision. The type of eye doctor a patient uses is largely a matter of personal preference if the eyes are healthy and don’t require specialized medical or surgical treatment. There are two types of eye doctors: optometrists and ophthalmologists. Both perform routine eye exams […]

Claims Processing: Dental Claims vs. Medical Claims

There are some similarities between preparing dental claims and medical claims. For example, patient and insurance demographics and insurance information that must be provided to medical carriers are similar. However, there are some very significant differences between the two. While dental carriers typically require a procedure code. Medical carriers not only require procedure code(s) but […]

Medical Claims Processing: How Do Medical Claims Work?

The medical claims industry is only a small part of the trillion dollar healthcare field. However, it is arguably one of the most important aspects for providers, as the medical claims process allows physicians and practitioners to maintain their clinics and businesses by receiving payment for their services. Let’s take a look at how medical […]

2016 Medical Claims Processing: Who Determines the “Value” of Value-Based Payments?

With all the discussion around value-based payments and quality-incentive programs newly instituted by Medicare, one begs to question…who decides what’s quality? How do we know that what’s considered value to one is legitimately valuable to everyone? Of course the answer to both questions is relative. In terms of medical care (and most everything else for […]

Medical Claims Processing: Practice Accelerator™ Part 2

Previously we learned The Practice Accelerator™ is a proprietary process Apex EDI has developed to help healthcare professionals to receive the benefits of clearinghouse services from Apex EDI. This detailed step-by-step process will help office staff understand how Apex EDI will boost the financial performance of your practice. In this part of the series we […]

Medical Claims Processing: Practice Accelerator™ Part 1

The Practice Accelerator™ is a proprietary process Apex EDI has developed to help healthcare professionals to receive the benefits of clearinghouse services from Apex EDI. This detailed step-by-step process will help office staff understand how Apex EDI will boost the financial performance of your practice. In this two part series we will cover the two […]

Medical Claims Processing: Your Account Managers Are Your Best Resource

At some point, you may need to contact Apex EDI to ask a question or troubleshoot an issue. One of the major components of our business philosophy is the support we give our clients. Your account manager is your best resource for help getting your claims successfully submitted. We recently learned that optometry clients had […]

Medical Claims Processing: Life Made Better

At some point in our life we each need a little help. At Apex EDI we have set the goal of making everyone's life we touch to be made better by their association with Apex. It's a lofty goal but we are going for it. Recently we partnered with a local charity to provide meals […]

Medical Claims Processing: 5 Reasons EHR Helps Practices

Recent healthcare reform provisions will take years to implement, but the HITECH Act and its Meaningful Use provision is quickly beginning to influence greater adoption of Electronic Health Records (EHR). While Apex EDI does not need to seek Meaningful Use certification many of our partners will and together we play an important role in individual […]