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Services for Providers

Key Features


Eligibiity

Support

Automate transactions using SFTP or API

Easy appeal generator.

CLAIM.MD does not sell your providers income or de-identified claim data.


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Fix rejected claims in real-time to speed cash flow and eliminate delays

Our Visual Claim Editor is totally unique -- an interactive claim form that performs payer-specific edits as you type. We translate arcane codes and messages to be readily apparent to your billing staff. Editing claims online with real-time data validation makes for fast turn-around of claims that you would otherwise need to re-bill from scratch.

Manage Claims with confidence.

If we don't receive an expected payer response in a timely manner, we'll alert you to the issue. When re-sending claims is required, one click does that for a single claim or an entire group of claims.

Revenue Cycle follow-up is time consuming and costly; CLAIM.MD specializes in showing you what you need to know, when you need to know it. Spotting issues before they impact cash flow is key to effective electronic billing. Our visual interface shows potential problems at a glance, with one click access to relevant detail so you can make the most of your investment in follow-up time.

Track claims from submission to remittance, with detailed claim history to prove timely filing.

CLAIM.MD gives you control of your claims throughout the entire lifecycle of the transaction. Regain confidence in your electronic claims with detailed claim history and tracking, which shows all vital claim level statistics with a single click (e.g. proof of timely filing, payer responses and payments). You get the data you need, when you need it -- no more, no less.

All claim documents, from eligibility to remittance, are searchable in a concise and easy-to-read (and printable) Claim History. Time stamped field level tracking records all changes made to the claim through time, and the Claim History includes all electronic payer responses as well.

Download Remittances as ERA 835 files for posting into your practice management system (or PDF for printing/storage), or you can simply view payments online. Search through up to 10 years of remittances history using our easy online tools. Remittances are automatically linked to their associated claim.

10 Years of History

CLAIM.MD will maintain your data for up to 10 years. Bill with the security and knowledge that your claim history will be available even when switching between billing systems. Likewise, as data formats and standard change through time, we maintain compatibility so you never have "obsolete" data that you are unable to use when needed. For active account holders, CLAIM.MD maintains claim history and ERA for up to 10 years.

Know at a glance when payers are slow to respond to claims

We provide automatic alerts when an expected remittance hasn't posted in a timely manner. You have one-click access to the claim history when you contact the payer to check status on the claim and track the missing response or remittance. Notes that you make during the follow-up process are stored in the Claim History for future reference.

Claims that Require Documentation Attached.

Electronic attachments to Medicare, Workers comp and many commercial payers. "Attach" PDF documents directly to claims just like sending a photo with an email.

Some Medicare billing scenarios require that you send Faxed Claim Attachments. We automate the entire process for you -- handle it all in a single step, as simply as clicking a file to "attach" the document to the claim (just like sending a photo with an email). You get a confirmation that they received the entire packet, and we take care of the hassles of filling out the "PWK" paperwork and tracking successful submission.

Workers Comp and Auto Accident claims have typically had to be filed on paper and sent with detailed progress notes to the claim adjuster assigned to the case. That process is slow and inefficient. Other EDI clearinghouses use delayed fax cover page response methods to request further information from you days after you have sent the claim. With CLAIM.MD, just click "Attach" on any Workers Comp or Auto claim to send your documents embedded with the initial claim. You can do it all in one step, and you get a confirmation that the payer received it correctly!

Instant 5010 Compliance for any billing system. (837/835/270)

Automatic up conversion of any supported claim format (ANSI X12 4010, NSF or Print Image) to X12 5010 837P and 837I. Even more, CLAIM.MD can downgrade 5010 835 (Electronic Remittance) to 4010, so you can continue to use your existing Practice Management software with no changes or upgrades required.

Upload claim files or create claims online.

When you enter or upload claims, you'll know instantly which claims fail our initial payer specific edits, or custom edits we have added that apply only to your account. Create or edit any claim using our visual claim form.

If a payer ultimately rejects a claim that is transmitted through Claim.MD, our Manage Claims tool alerts you to the problem right away. Easily edit, correct and resubmit in real-time. Never again will you miss a rejected claim because you overlooked it in a long cluttered report.

See first hand where your billing stands

A picture is worth a thousand words. CLAIM.MD has a revolutionary new visual approach to "traditional" reports -- instead of giving you lists with details and totals, we use interactive graphs that allow you to expand all the way into the associated data. Reports include:

  • Age of Charges Billed
  • Daily Billing Summary (claims uploaded, transmitted, rejected)
  • Billed Charges by Payer, Provider, Procedure or Diagnosis
  • Patient Geographics by Payer, Procedure or Diagnosis

Claim Appeal Packets

Sometimes payers either deny claims or pay them incorrectly, and nothing will take the place of sending a "paper appeal" that you print and mail directly to the payer. Traditionally that takes a lot of work to gather all the claim history and payment responses. Claim.MD automates that entire information gathering process - just click the Printer icon, and we gather all the important data into an easy Appeal Packet.

One click access to personalized expert support

You may never need it, but when you do you'll be happy you have CLAIM.MD for support. Our support interface allows you to request help at the touch of a button. Click GetHelp from any Claim, ERA or Eligibility to open a support ticket. Everything about the transaction in question is automatically transmitted to our support team, so we have instant access to the complete history when we begin researching your issue. No need to re-enter all the associated claim data, or login to a clunky external portal. Our support system is fully integrated into our claim management portal. Personalized U.S. based support has never been so easy or efficient!

Provider Privacy

Unlike many medical EDI clearinghouses CLAIM.MD will never sell your providers income or de-identified claim data to data mining companies. We value your privacy, and your data is secure.

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