Secondary Claims Processing at Your Fingertips

Secondary billing is exactly as the name suggests, the process of billing a second policy or payer once the primary claim has been processed and the reimbursement posted. Learn how to simplify the process with software like Apex EDI.

Why Was My Claim Returned?

Why was my claim returned?

The primary responsibility of a medical biller is to properly file claims to ensure that the medical provider is reimbursed for services rendered. Unfortunately, it is not uncommon for billers to make human or electronic errors while entering claim data. As many as 80% of medical bills contain one or more errors that increase the […]

What You Need to Know about Denied and Rejected Claims

Billing employee frustrated on the phone over denied and rejected claims.

Denied and rejected medical claims can erode a significant chunk of your practice’s revenue, especially if you’re not set up to manage them efficiently. The good news is that the majority of rejected and denied claims are preventable and caused by common errors. You can make a big difference in your claim rate by identifying […]

4 Keys to Submitting Claims Successfully

Doctors and billing team working together to submit claims more successfully.

Submitting claims requires an A-list clearinghouse. Let’s face it. The claim management process is quite tasking, and without the right intermediary, getting what is due to you can be an uphill task.  A slight delay or an unsuccessful claim could mean poor cash flow for your organization. In today’s post, you’ll discover what it takes to file […]

Medical vs. Vision Care Claim Processing

An optometrist performing a routine eye exam on her patient. 

Handling claims regarding optometry and ophthalmology can entail a string of tiny details, including differences between billing to a vision plan versus what you should bill through a patient’s medical insurance. Differentiating between the two can often be a little confusing at first, and that’s okay. To make things easy, let’s review what the differences between both […]

8 Benefits of Using a Claims Clearinghouse for Medical Billing

Health insurance has always been a highly debated topic. With more people using a larger variety of health insurance options, we ultimately have more insurance claims to file. Unfortunately, this means medical associations and individual practitioners often find themselves bogged down with more and more paperwork and medical billing can become overwhelming.   Medical claims processing can be […]

What percentage of submitted claims are rejected?

As reported by the AARP1, estimates from US Department of Labor say that around 14% of all submitted medical claims are rejected. That’s one claim in seven, which amounts to over 200 million denied claims a day. There are legitimate reasons that a claim can be denied, but it’s not unheard of for insurance companies […]

7 Medical Procedures for Which You Cannot File Claims

Health insurance is an extremely complicated process, and very much a hot topic these days. Even if you’ve read your enrollment brochure cover-to-cover, it’s still possible to miss some of the details of your coverage. With so many plans, exceptions, restrictions, and limits, it’s easy for your insurance to catch you off guard when it […]

6 Most Important Medical Billing Reports

Ensuring that your practice is functioning efficiently involves investigating many things. One of the parts of your practice that needs to be working smoothly is your billing process. Medical billing reports are an important way to learn about this. They can give you vital information about claims, payments, and a variety of other aspects of […]

Does EHR Adoption Really Lower Administrative Costs?

The government mandated adoption of electronic health records (EHR) systems claims the change improves patient care and reduces costs for healthcare providers. Healthcare providers adopted systems in stages to meet the requirement, hoping costly implementation would eventually pay off. Many facilities aren’t seeing the benefits they’d hoped for. The results are leaving many providers skeptical […]