Billing Service Software: Medical Claims Management

The AdvancedMD Medical Billing Service Software Claims Center provides the most convenient way for your physicians to track and manage your medical claims from posting through payment. Plus, with AdvancedMD Software Claim Inspector, the claims will go out correctly. That means you will receive revenue quicker and save time doing research on rejected claims.

Track Medical Claims From One Convenient Software Screen

From the Claims Center, you can do all of the following:

• Review claims - If a provider or other employee is set for charge review, charges posted will show up here for review before final posting.

• View unbilled medical claims - Claims that are incorrectly posted with errors, such as a service date outside the range of insurance coverage are refused and show up on a convenient work list. Claims rejected because of problems found by the Claim Inspector also show up on this unbilled list.

• View exclusions - If the clearinghouse discovers errors and does not bill a claim to an insurance carrier, that exclusion will show up on the software exclusion work list.

• Track claim runs - The Run Alerts tab on the Claims Center lets you track claim runs and includes alerts for potential problems. The Track Claims feature prompts further investigation when payments have not been received after a user defined period.

• Keep track of all reports from carriers and the clearinghouse - The EDI Reports tab collects all the reports for electronic medical claims in a single location. This allows you to easily track the process of claims through the clearinghouse and carrier when using electronic billing service software remittance.

Reduce Denials With the Medical Claim Inspector Software

The AdvancedMD Medical Billing Service Software Claim Inspector scrubs your claims before you hit submit. It includes more than 3.5 million edits for CCI, HIPAA, LMRP, and carrier-specific problems. All this makes it easier to fix your claims prior to submission, which means fewer denials.

No-Hassle Medical eClaims Software

For rapid claims payment, use AdvancedMD Software eClaims. We offer top clearinghouse partners and secure Web transmission direct from your desktop. Say goodbye to the end-of-day modem hassle forever!

With AdvancedMD eClaims billing service software, you can enjoy:

• Rapid online reports for each claims submission batch
• Denial management reports
• Electronic auto-posting (ERA) of payments directly back to charges (where available)
• Reduced overall reimbursement cycle time

The following electronic transactions can be seamlessly accessed from within the medical billing service claims software:

• Claims (HIPAA ANSI 837): Electronic medical claims submission allows you to submit claims daily that means faster reimbursement. In the limited cases where payers do not accept electronic claims, a practice or billing service can elect to have these claims automatically printed and mailed by AdvancedMD Of course, practices can still print demand claims on HCFA 1500 forms for direct submission.

• Electronic Remittance Advice/ERA (HIPAA ANSI 835): With ERA the practice receives an electronic remittance (i.e. an electronic EOB) transaction that can be reviewed in the software system and automatically post payments by procedure. Automatic posting this data improves accuracy, reduces data entry costs and results in rapid patient statement processing. There is no need to wait for the paper EOB to arrive in the mail.

• Patient Statements (Not a HIPAA transaction): Electronic medical billing statements allow your practice to automatically generate and mail daily statements while avoiding the costs of stamps, stationery, envelopes, printing, sorting, stuffing and addressing.

• Eligibility (HIPAA ANSI 270 Request/271 Response): Prior to seeing a patient, obtain information on a patient's eligibility as well as their co-pay, remaining deductible and other coverage details.

• Get the codes you need instantly, for no extra charge. Imagine having a completely searchable, easy-to-use online codebook right in your billing service software. That's what you get with AdvancedMD. Your medical billing service software subscription includes the following codebooks at no extra cost:

  • ICD-9

  • CPT

  • HCPCS

• Easily search codebooks and import only those codes you need on your Online Charge Slip. This helps you keep your pick lists short and manageable. We'll provide all the annual code updates. Our search utility makes it simple to find the new, deleted or changed codes.

Use Whichever Claims Forms You Need

AdvancedMD medical billing service software supports both professional and institutional forms so individual providers and institutions alike will find it easier to bill appropriately and get proper reimbursement. Continue using your own charge codes-simply map them to the appropriate revenue codes during setup and carry on as you always have.