Electronic Data Interchange (EDI)

Perform Daily Tasks Electronically Electronic Data Interchange is the process of performing daily tasks electronically rather than manually. All the major insurance carriers have a dedicated EDI Department. This department helps you enroll providers, process requests, and ensures all systems run smoothly. There are numerous benefits to using an EDI—for instance, you can send and...
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Creating a Checklist

Charge Entry Checklist A charge entry checklist can assist your staff in capturing all the necessary data and in turn increase revenue in the clinic. Before you enter charges, KMC University strongly recommends that you take full advantage of all the training modules and guides provided by your practice management software. This is the only...
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Mapping Charge Entry Data

Ensuring Charge Entry is Successful Are you struggling with a long list of rejected claims, incorrect statements, and piles of paperwork that need to be entered? Before you blame the software, take a closer look at you and your staff. Have you taken the time to learn about your practice management software and all the...
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1st Party vs 3rd Party

Understanding the Difference Between the Two Types of PI Claims You will generally experience two types of personal injury insurance claims with your patients: first-party claims and third-party claims. With a first-party insurance claim, your patient files with their own insurance carrier; for a third-party insurance claim, your patient files against the insurance carrier of...
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Medicare Timely Filing Guidelines

How Much Time Do You Have? We are often asked how much time an office has to file claims to Medicare. This is of particular interest when Medicare is a secondary payer, and the office must wait for the primary carrier to pay or deny before billing. Medicare Timely Filing is addressed in Section 6404...
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Par VS Non-Par Comparison

Differences Between Participating and Non-Participating Providers This image provides a snapshot of the difference between Participating Providers and Non-Participating Providers in the Medicare Part B program. This at-a-glance image demonstrates how the obligations are slightly different between the two options. Participation status is a highly personal decision for providers, but it should be noted that...
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