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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.

Asian businessman pointing at past due medical bill with dunning expression.  Isolated on white background.

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.

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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.

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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.

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Medical Billing Clearinghouse: What Is a Clearinghouse Service?

Medical Billing Process

can become increasingly complicated as a healthcare practice grows. A clearinghouse service, like Apex EDI, helps eliminate billing errors and ensure claims are paid on time by working as an intermediary between the provider and insurance company.

We check to make sure no errors are made before submitting claims for payment. All procedural and diagnosis codes are checked for validity before being submitted to the insurance company. We also ensure that each procedure code is appropriate for the diagnosis code that accompanies it.  

Another benefit of working with a clearinghouse is that you don’t have to worry about technical compatibility. There are many different billing software systems and the insurance company’s payments systems are not always compatible with them. When needed, Apex EDI can even partner with a number of other clearinghouses to ensure that all claims are processed on a timely basis. This means you receive payment without the worry.  

A clearinghouse takes away the stress of managing the interconnection between software systems, formatting issues, and the ongoing hassle of managing technology issues for you. Every time a medical claim is transferred, there are chances of it being lost, stalled, or denied. We want to minimize those chances for you.  

Apex EDI works with providers and insurance companies to help you avoid the billing headache, eliminate errors, process claims, and receive payment on time. If we can help you get paid sooner without the hassle, it will be well worth the investment. We know we can make a positive impact on your healthcare business. Contact Apex EDI today for a free demonstration of our software.

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Medical Billing Clearinghouse: Avoid Medical Claims Billing Problems

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All providers want to be reimbursed promptly and accurately for their services. Unfortunately, human and electronic errors are unavoidable and can slow down medical claims processing. Our goal at APEX EDI is to reduce as many of these delays as possible and accurate reimbursement.

There are some very basic information errors that can be quickly eliminated by using a medical claims software. Inaccurate patient information such as a misspelled name, date of birth, address, or insurance ID number can lead to a rejected claim.

Mismatching medical codes or confusing ICD, CPT or HPCS codes can result in too many or too few digits for a claim to be processed. Insurance policy numbers, addresses, and contact information can also be difficult to enter correctly when required numerous times during service. If you can reduce the number of these simple errors in your medical billing, you’ll have a much higher percentage of claims that pay you for service quickly.

Poor documentation and misinformation such as coding for a less serious or extensive procedure than the patient received can also cause serious problems. Intentionally misrepresenting the work performed on a patient is considered fraud and illegal, even when the intent is to help the patient save money.

It’s important to stay current on medical billing regulations and be proactive by preventing problems before they occur. Always have clinic staff double check for errors and communicate quickly about any billing questions. At Apex EDI, we have a highly trained team of experts ready to answer questions about billing regulations.

Our software can also help eliminate many simple billing errors. The investment in a few preventative actions and tools will pay off greatly. You will have the peace of mind knowing your medical claims are being handled with speed and excellence.

Contact Apex EDI for a demonstration of our software today.

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