Why you should use EDI and Medi-Claims, LLC

Electronic Data Insertion (EDI) is the new technology used for Electronic Claims Processing (ECP) for faster claims submissions to insurance carriers and faster payments to healthcare providers. A recent study showed that medical claims were underpaid over $5 billion annually and fewer than 6% were resolved to provide proper reimbursement. Read on to learn how we can probably help you if you submit paper claims or have your staff do it electronically from your office.

Paper claims submission is time consuming, expensive and results in preventable delays in getting paid. There are 11 steps and chances for errors in paper submission of insurance claims--21 steps if a claim gets rejected. This effectively gives the carriers several built-in reasons to delay payments to healthcare providers from 45 to 90 days and results in claims going unpaid. It is not uncommon for paper claims to experience 20% to 30% rejection rates. Just the fact that the forms are mailed usually results in payment at least 30 days after submission. Rejections can mean hours on the phone just trying to find out what the error was.

In comparison, Medi-Claims and the EDI Healthcare Network electronic claims processing reduces this to 4 steps and usually results in payments in 10 to 14 business days and less than 3% rejections. We do all the work for you to covert your normal paperwork or computer form into the standard format required for immediate electronic insertion and processing by your insurance carriers' computers. Then we electronically submit your error free claims using our proprietary software and extensive EDI network of partners. Our system tracks claims with errors and helps us identify what corrections need to be made so they will be accepted by your carriers. This significantly reduces rejected claims and delayed payments.

We urge you to try our Risk Free 30 day trial before you purchase any software or program for your staff to electronically submit claims directly from your office. We offer a low fixed cost per claim outsourcing that eliminates your staff from having to learn any new system or get retraining with each update or personnel turnover. Please note that not all electronic submission systems are the same, and many simply eliminate the mailman without fully meeting the changing Electronic Claims Processing standardization requirements dictated by HIPAA and insurance carriers. Others have annual subscription fees, minimum number of transactions, higher costs for more insurance carriers, etc.

If you are currently submitting claims electronically from your office, ask yourself or your Office Manager these questions.

Does your staff like doing the claims submission work, or do they dread it?

• Are you typically getting paid in 10 to 14 business's days and experiencing less than 3% claims rejections?
• Does your program audit your claims for mistakes before submitting them?
• Does it only submit error free claims to the insurance carriers?
• Does it provide claim submission status reports within 48 hours?
• Does your staff have the time to follow up on rejections so you get paid?
• What is the value of your current pile of rejected claims?

The odds are that if you are paying $10 an hour or more, have 40 or more claims a week, or answered NO to any of the above questions --then Medi-Claims can save you time and money by doing your electronic claim submissions for you. If the value of your current pile of rejected claims is over $10,000, you should definitely be talking with us.

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