Apex EDI Clearinghouse Review


Here is the complete 2019 clearinghouse review for Apex EDI. CH.org does its own primary research and interviews the clearinghouses personally with standardized criteria important for billing managers to obtain accurate data. The information below is provided directly from Apex EDI to Clearinghouses.org and is reliable.
1. Call Wait Times. (how long do I have to wait to talk to support?)
Our average hold time is less than 2 minutes.
2. Payer List. (Do you have connectivity to the payers that I need to send claims to?)
3. PM Spport. (Does your company integrate with my PM system? Is your support staff knowledgable about my PM?)
We work with hundreds of PM systems – and we are constantly adding new ones to the list. Due to our exposure to so many systems we can sometimes answer your PM questions, but if we can’t we are happy to help you find the answer with your PM.
4. Missing Claims. (My payer does not show as having receieved my claims. I don’t want to wait 2-3 weeks to find this out. How do I tell in real time if I have missing claims?)
While many clearinghouses only display their edits and then the EOB information, we have worked with insurance companies to also make their initial edits available to you. This means that right after an insurance company has received your claim they will let you know if they have accepted it into their system or if they have found anything wrong. This allows you to make the corrections you need to very quickly.
5. Claim Scrubbing & Validation. (What are your rejection rates? To high = Too many payer denials. Too low = Too many EDI rejections).
6. RCM Dashboard — to detect slow payments, cash-flow issues, and excessive A/R days. Does your service help me manage unattended Claims, manage rejections and denials. Does it report errors as codes or as full explanations. Does your service report back to my PM with error messages, ERA’s, ect.?
Our friendly UI helps your office work through problems quickly and easily. Our reports and EOB viewers help you see and fix any claims that need corrections, helping you with your AR needs. Depending on your PM our system might integrate more completely into your system.
7. Real Time RCM Reporting. (Do I have to wait untill the end of the month to detect blocked cash-flow, lost or unattended claims?).
With our reports functionality you can quickly see what claims are being denied from the insurance company quickly – not having to wait until you run your A/R reporting.
8. Patient Payments. How does your service help me estimate payment responsibility to determine the patient portion upfront, so our front office can collect patient payments during the appointment.
We do not do this yet.
9. Analytics. How does your service/technology give me insight into financial and operational performance across our organization
We do not have this kind of functionality yet.
10. Proactive Revenue Controls. How does your system proactively and continually monitor key performance indicators (KPIs) to enable us to act in real-time to address revenue leakage before it significantly impacts our cash-flow?
Our various claim tracking features will allow you to see and fix problems right after they happen. That way they never become major KPI problems.




Medical Claims Clearinghouse Ratings and Reviews