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Why You Need to Secure Your Claims Processing

Health insurance has been a highly debated topic over the past few years. With the Affordable Care Act, we have more insured Americans than ever before. 

With more people using various forms of health insurance, we also have more insurance claims to file. This often means that medical associations and individual practitioners are getting slammed with more and more paperwork. Medical billing can be overwhelming.

Medical claims processing can be a stressful ordeal, so let us help you figure out what you need to know.

How medical claims processing works

We live in a world where technology is expanding at unbelievable rates. With this massive growth, the way we do things is constantly changing. What was commonplace even a few years ago may be obsolete now.

The medical field is no different. While we all know that medical procedures have changed drastically over the past decade, many people don’t consider how much the work behind the scenes has changed.

Whether you have been in the field for years or are just starting, we’ll show you what you need to know.

The old way

Let’s start by looking at the traditional process of medical claims processing. We’ll paint the picture. 

It’s a Tuesday morning and you’re still working on claims from last week. You have a pile of files on your desk. They are medical claims that need to be filed with several insurance companies.

They are sorted into distinct piles based on where they should be submitted. It’s a lot to keep track of. You diligently fill out the forms. After a few hours, you can feel that familiar tension building between your eyebrows.

Now that you’ve started to make a dent in your first pile, it’s time to start correcting the older, rejected claims.

The first few go quickly. Silly mistakes, typos, and an incorrectly spelt name. You can’t believe you missed these the first time, but at least they’re easy to fix.

Suddenly, you get stuck on one. You can’t see anything wrong with the form and you’re not sure why they denied it.

You glance at your phone, then decide to set the file aside so you can deal with it later. You have too much to do to spend a half-hour on the phone with an insurance company right now.

By the end of the day, you’re even more behind than you were this morning. Then you see that file next to you. You forgot about it. So you call the insurance company.

20 minutes later, you still aren’t sure what went wrong, so you put down the phone.

If this sounds familiar, rest assured that there is an easier way. 

The new way

Now imagine it’s Friday and you aren’t behind at all. You started using a clearinghouse for your medical claims processing. The process seemed so different at first, but you’ve gotten used to it and now it feels like second nature.

You simply log into the clearinghouse and upload your files. After a few minutes, you notice that several were flagged, so you quickly go in and correct the problems. 

Then, the forms are sent to the insurance companies, so you don’t have to think about it much. 

In fact, you’re already getting reimbursed for claims filed a week ago!

You can do more claims quickly and you know that it’s secure and HIPPA compliant. You finally feel at ease.

Benefits of using a clearinghouse

The new way of medical claims processing simplified life for those of us who do regular billing.

Whether you’re an individual with a private practice or the head of a medical claims processing department that bills for many healthcare processionals, a clearinghouse can help you.

But a more enjoyable workday isn’t the only benefit of a clearinghouse. In fact, we have a list of ways this service can help you!

Fewer problems

Using a clearinghouse for your billing can drastically reduce the number of errors in your claims. In fact, the average error rate for claims submitted electronically through a clearinghouse is 25% lower than those submitted by paper.

Make changes quickly

When you do have an error that the clearinghouse catches, you can correct it quickly. Before it is submitted to the insurance company. This means that you are fixing the problem in a matter of minutes, rather than weeks.

An extra set of eyes

Since the clearinghouse catches so many little mistakes, you can trust that you’ll have fewer claims denied. It’s nice to have someone looking out for you! 

Batches of claims

Since clearinghouses do medical claims processing for a number of insurance companies, you don’t have to sort them on your own like you did when you submitted claims to each company separately. Instead, you can simply upload all of your claims at once.

Fewer headaches

For those moments when you do have trouble with something, you can be assured that you’ll have someone (other than the insurance company) to call for help. The customer services that goes along with a clearinghouse means you won’t have to figure out everything on your own.

Accurate picture of finances

Because the clearinghouse streamlines the process of medical claims processing, everything moves faster. Instead of waiting weeks or even months for an insurance company to reimburse you, you may only have a wait a few days. With less to keep track of, you’ll know where you stand financially on a more immediate basis.


You know that the clearinghouse uses HIPPA compliant procedure, so you don’t have to worry as much about potential violations.

Save money

Another important benefit of a medical claims processing service is the fact that it will save you money. Because of the streamlined process, fewer steps means you won’t need to spend as much time billing insurance companies.

With less time, you need as many people working on billing. A smaller staff means fewer expenses.

Next steps

Now that you’re ready to work with a clearing house for your medical claims processing needs, what’s next?

Choosing a reliable company is absolutely crucial when you’re dealing with sensitive medical information. Make sure you’re in the right hands.

We offer a free live demo of our software, so you’ll know exactly what you’re getting before you commit. If you have any questions, don’t hesitate to contact us.

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Apex EDI, Inc.
556 E Technology Ave
Orem, Utah 84097
Support: (800) 840-9152
Sales: (801) 383-0388
Fax #: (801) 642-0333
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