Send electronic claims directly to selected insurance carriers

Lightning-Fast Insurance Claims!

Many health care billing programs can send insurance claims with a modem. MediSoft has many options for electronic claims -- from clearing house claims for easy, universal access, to direct electronic claims modules for selected insurance carriers that eliminate per-claim fees. All MediSoft software includes clearing house electronic claims software at no extra charge.

Electronic Claims are Faster than Paper

Electronic claims significantly reduce the amount of time a practice waits to be paid for their services. On average, electronic claims are paid in half the time of paper claims. Electronic claims improve payment speed in two ways: First, the mail system is avoided. An electronic claim can arrive at a carrier's office within 24 hours and be ready to be paid by their computer. Contrast this with the time it takes for the post office to deliver the mail and data entry staff at the carrier's office to enter the claim information! Second, insurance carriers give priority processing to electronic claims. Medicare processors cut two weeks off their payment time to give providers the incentive they need to send claims electronically!

Which Claims Can Be Sent Electronically?

MediSoft Direct Electronic Claims software is offered for selected insurance carriers. Medicare, Medicaid and Blue Cross/Blue Shield accept claims directly from providers and billing services in most areas. Few other carriers offer this option, making MediSoft clearing house claims the perfect partner with direct claims modules in most practices.

Electronic Claims are as Easy as Paper

Billing data is entered into MediSoft, then is used to print paper claims or submit claims electronically. No additional data entry is required -- Just select the Electronic Claims menu option!

Free Electronic Claims Software Isn't Free

Carrier-supplied software works differently than MediSoft, requiring extra time to learn and use. Claim information sometimes must be entered a second time to use carrier-supplied software. MediSoft Direct Claims modules work inside MediSoft, using the same familiar menu structure and commands.

  • Carrier Tested and Approved
  • Works Inside MediSoft
  • No Data Reentry
  • Usually No Per-Claim Fee

Clearing House Claims

NDC Health EDI Services

MediSoft recommends clearinghouse services of National Data Corporation (NDC).

NDC Health EDI offers electronic claim submission services for Medicare, Medicaid, Blue Cross/Blue Shield and commercial carriers in most states. NDC's offices are located in Atlanta, Georgia, but all claim submission and support calls are made on toll-free phone lines. NDC submission software is included with all MediSoft and PractiSoft products.

When you use NDC electronic claims services you get these advantages:

  • All claims for Medicare, Medicaid, Blue Cross/Blue Shield and commercial carriers are sent to one location with one telephone call.
  • Claims are immediately edited for valid content. Claims are checked for missing information, valid procedure and diagnosis codes, and other information specific to the carrier for which the claim is intended
  • A report is returned in the same telephone call detailing which claims were accepted and forwarded and which claims were rejected, along with information on how to correct the claims.
  • All carriers' claims may be sent to NDC. If an insurance carrier cannot accept claims electronically, NDC will laser print and mail a paper claim form.
  • NDC electronic claim submission software is included free with every MediSoft program - There's nothing more to buy
  • Beginning users find that NDC's editing services make electronic claim submission easier. Users learn from NDC's edit reports, helping to avoid future claim rejections.

Good news for billing services! NDC has recently changed the way you pay for clearinghouse signup. Instead of the old $300 support fee plus $50 per provider, billing services pay the same setup fee as a healthcare practice - just $125 per provider tax ID number. And NDC submission services are affordable -- Each claim costs just thirty nine cents.

If you have any questions please email us:
EMC@medical-billing-software.net


Direct Electronic Claims Modules

When a practice sees a concentration of patients who are insured by a particular insurance carrier, direct insurance claims can save the per-claim fee common with claims clearing houses.

Currently Available Direct Claims Modules

Following are currently available MediSoft Direct Claims modules. Direct electronic claims modules are available for MediSoft for DOS and MediSoft for Windows. Availability of ERA Auto Pay, a MediSoft product for automatically applying payments based on Medicare's electronic remittance advice, is noted in the ERA column. Contact your independent MediSoft dealer or MediSoft for details.

State

Code

Carrier

Claims Accepted

ERA

AK

AEMA

Aetna (submits to BC/BS of ND)

Medicare Part B

Y

AK

WMSC

Premera Blue Cross

Medicare Part B, Blue Cross and Blue Shield, Commercial

 

AR

ARMB

Blue Cross and Blue Shield of Arkansas

Medicare Part B, Blue Cross and Blue Shield

AZ

AEMA

Aetna (submits to BC/BS of ND)

Medicare Part B

Y

AZ

APN1

Arizona All Payor Network

Medicare Part B, Blue Cross and Blue Shield, Commercial

CA

CATA

Transamerica Occidental Life and Casualty

Medicare Part B for Southern California

Y

CA

CABS

National Heritage Insurance Company

Medicare Part B for Northern California

Y

CA

CAMC

MediCal

MediCal

 

CO

NDMB

Blue Cross and Blue Shield of North Dakota

Medicare Part B

Y

CT

TRMB

United Health Care

Medicare Part B

Y

DE

MDTB

Maryland Trailblazers (DOS only)

Medicare Part B

DE

DETBW

Delaware Trailblazers (Windows only)

Medicare Part B

Y

DC

MDTB

Maryland Trailblazers

Medicare Part B

Y

DC

MHIN

Maryland Health Information Network

Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial

 

FL

FLMB

Blue Cross and Blue Shield of Florida

Medicare Part B, Blue Cross and Blue Shield, Health Options, Champus, Commercial

Y

GA

AEMA

Aetna (submits to BC/BS of AR)

Medicare Part B

 

HI

AEMA

Aetna (submits to BC/BS of ND)

Medicare Part B

HI

HMSA

Hawaii Medical Service Assoc.

HMSA, Quest, Medicaid

 

IA

INET

Iowa INET

Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial

IL

ILBB

Blue Cross and Blue Shield of Illinois

Medicare Part B, Blue Cross and Blue Shield, Medicaid, Champus, Commercial

Y

IL

WPSI

Wisconsin Paperless System

Medicare Part B

Y

IN

AIM1

Indiana Administar

Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial

 

KY

KYMB

Administar Federal of Kentucky

Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial

LA

ARMB

Blue Cross and Blue Shield of Arkansas

Medicare Part B

 

MA

NHIC

National Heritage Insurance Company

Medicare Part B

Y

MD

MHIN

Maryland Health Information Network

Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial

 

MD

MDTB

Maryland Trailblazers

Medicare Part B

Y

ME

NHIC

National Heritage Insurance Company

Medicare Part B

Y

MI

WPSI

Wisconsin Paperless System

Medicare Part B

Y

MN

TRMB

United Health Care

Medicare Part B

Y

MO

ARMB

Blue Cross and Blue Shield of Arkansas

Medicare Part B for Eastern Montana

MS

TRMB

United Health Care

Medicare Part B

Y

ND

NDMB

Blue Cross and Blue Shield of North Dakota

Medicare Part B, Blue Cross and Blue Shield

NH

NHIC

National Heritage Insurance Company

Medicare Part B

Y

NJ

PABS

Pennsylvania Electronic Medicare Service

Medicare Part B, Blue Cross and Blue Shield, Commercial

Y

NM

AEMA

Aetna (submits to BC/BS of AR)

Medicare Part B

Y

NM

ARMB

Blue Cross and Blue Shield of Arkansas

Medicare Part B

NV

AEMA

Aetna (submits to BC/BS of ND)

Medicare Part B

Y

NY

GHI1

Group Health Incorporated

Commercial

NY

NYGH

Group Health Incorporated

Medicare Part B for Queens

Y

NY

NYUM

New York Upstate Medicare Division

Medicare Part B for Upstate Area

Y

NY

NYEB

Empire Blue Cross and Blue Shield

Medicare Part B, Blue Cross and Blue Shield, Commercial

Y

OH

OHMB

Nationwide Mutual Insurance

Medicare Part B

Y

OH

AIM1

Indiana Administar

Blue Cross and Blue Shield, Commercial

 

OK

AEMA

Aetna (submits to BC/BS of AR)

Medicare Part B

Y

OK

ARMB

Blue Cross and Blue Shield of Arkansas

Medicare Part B

 

OR

AEMA

Aetna (submits to BC/BS of ND)

Medicare Part B

Y

PA

PABS

Pennsylvania Electronic Medicare Service

Medicare Part B, Blue Cross and Blue Shield, Commercial

Y

SD

NDMB

Blue Cross and Blue Shield of North Dakota

Medicare Part B

Y

TX

TXBB

Texas Health Information Network

Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial

Y

VA

TRMB

United Health Care

Medicare Part B

Y

VT

NHIC

National Heritage Insurance Company

Medicare Part B

Y

WA

AEMA

Aetna (submits to BC/BS of ND)

Medicare Part B

Y

WA

NDEX

Network Data Express

Medicare Part B, Blue Cross and Blue Shield, Medicaid, Department of Labor and Industries, Commercial

 

WA

WMSC

Premera Blue Cross

Medicare Part B, Blue Cross and Blue Shield, Medicaid, Department of Labor and Industries, Commercial

WI

WPSI

Wisconsin Paperless System

Medicare Part B

Y

WV

OHMB

Nationwide Mutual Insurance

Medicare Part B

Y

WY

NDMB

Blue Cross and Blue Shield of North Dakota

Medicare Part B, Blue Cross and Blue Shield

Y

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