General Claims Questions
How Par vs. Non-Par Payers Affect Your MEDENDx Claim Fees
Your claim submission fees are influenced by the payer's participation status on MEDENDx's Payer List—Participating (Par) or Non-Participating (Non-Par). Understanding this distinction helps you make informed billing decisions and monitor how claim activity may affect monthly charges.
Par vs. Non-Par Payer Defined:
Participating (Par) Payers - No cost for submitting claims to Par payers.
Non-Participating (Non-Par) Payers - Submitting claims to Non-Par payers will result in a Non-Par processing fee.
When do Non-Par Processing Fees Apply?
The Non-Par Claim processing fee is calculated and charged per unique Tax ID + Rendering NPI combination if any Non-Par claims are submitted within the month.
For Institutional claims:
If a Rendering NPI is not present, the Attending NPI will be used.
If neither Rendering nor Attending NPI is present, the Billing NPI will be used instead.
How to Monitor a Payer's Status
Use the Payer List on MEDENDx's website to check if a payer is Par or Non-Par.
1
Visit https://medendx.com/
2
Navigate to Resources > Payer List
3
Search for the payer
4
Non-Par payers will show a checkmark in the Non-Par column, whereas for Par payers, that column will be blank
Stay Informed:
Payer statuses can change so it's important to monitor the Payer List regularly. You can also monitor your monthly claim volume using the Par/Non-Par Report.