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 […]
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 […]
Claims Processing: What is Claims Adjudication?
This is a short summary of the claims adjudication process. For a comprehensive whitepaper outlining the entire process please complete the whitepaper download form below. 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 […]
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. […]
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 […]
Insurance Claims: Tips for Negotiating Claims with Insurance Companies
When healthcare providers and staff understand how to communicate with insurance companies, it can make billing and medical claims processing much easier. It’s not uncommon for an insurance adjuster to offer an initial settlement at a lower amount than you requested. Negotiating a final settlement can have a positive impact on your business. It’s imperative to […]
Oral Surgery Claims: Things You Should Know About Submitting Oral Surgery Claims
There are several costly mistakes oral surgeons can make when it comes to submitting oral surgery claims. The billing and coding challenges are unlike any other medical specialty. Apex EDI has the expertise and experience to make processing dental and oral surgery claims easier for you and your staff. First and foremost, it’s important to […]
Chiropractic Claims: Chiropractic Care vs. Physical Therapy
When a patient experiences a bodily injury or physical trauma that requires treatment, they may see a chiropractor and a physical therapist. Apex EDI is familiar with both types of claims. Chiropractors routinely diagnose and treat mechanical disorders of the musculoskeletal system. Physical therapists help restore physical mobility and functioning. Common chiropractic claims include the […]
Medical Billing Clearinghouse: What Is a Clearinghouse Service?
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 […]
Medical Claims Processing: Tips for Appealing a Denied Medical Claim
Medical claims may be denied for a variety of reasons. Fortunately, there are some ways for patients to appeal a denied claim within six months of the healthcare service. Follow these tips and you will have better success recovering denied benefits from your insurance company. First, it’s important to understand exactly why the claim […]
