Getting Started with Electronic Billing

Getting Started with Electronic Billing

This is an overview of the steps needed to bill insurance companies electronically.

This document assumes that all the basic account setup has been completed per the Getting Started with My Clients Plus guide:   Getting Started with My Clients Plus

Before you bill electronically:

Prior to submitting your first electronic claims, you'll need to complete these steps.

Payment & Subscriptions - A subscription for electronic billing should be chosen in My Payment Info and then Payment & Subscription.  Select Electronic Billing and Save.

Set up Insurance Companies - Insurance Companies

Pre-enroll with EDI - This step will not need to be completed for all insurance companies. You can review the Apex EDI Payer list to review which payers require EDI enrollment:  Apex EDI Payer List

To start an enrollment, you may go to Code Setup > Insurance Companies and click on the Apex Payer Enrollments button.   Complete the requested information.  This will generate a Madaket invitation that is emailed to you within 24 business hours:  Setting Up Your Madaket Portal and Initiate Enrollments

You can see more enrollment information in our Knowledge Base here:  Madaket Portal Information

To begin electronically billing claims:

Enter Client Sessions - Creating Client Sessions

Invoice Clients and Insurance - Invoicing Claims

Review Claim Status - How to View Your Electronic Claim Status

Post Insurance Payments - Posting a Payment From Insurance Company

Best practices:

1) It is important to go to the Balances Due You report on a regular basis to check your electronic claim status.  If there are any RED icons on this screen, you will need to take action to correct and resubmit the claims.  

2) Once payment is received, it should be posted in My Clients Plus.  Once a payment is posted, the client session (claim) will drop off the Balances Due You report. This will allow you to keep a cleaner record of what is outstanding.

3) It is recommended periodically that you go to the Balances Due You report and change the view to Billed more than 30 days.  If you are billing electronically AND regularly posting insurance payments, this view will show you anything that hasn't been paid and is more than 30 days old.  If there is anything on the report, it should be followed up on with the payer.  This practice will help keep your balances current and avoid unpaid claims.