You can also customize reports according to your business needs. It helps you streamline your business processes and gives better clinical outcomes. Improve care coordination by sharing treatment plans and lab results with patients. Patients can schedule meetings, submit intake and consent forms, pay bills online, request prescription refills and upload necessary documents via the patient portal. Integrate with Doxy. Generate and analyze operational reports to improve productivity. Waystar offers revenue cycle management RCM modules to help optimize financial processes.
Changes in payer policies, coding, staff turnover and other volatile factors mean that there are always challenges to overcome when maintaining a consistent and predictable cash flow. Waystar lets you stay on top of the ever-changing landscape of your revenue cycle by providing ongoing actionable data that is updated nightly rather than monthly as with many other solutions and points your staff to the specific issues impeding reimbursement.
This lets you focus on which claims and payers need attention to make immediate improvements and to prevent the same problems from resurfacing in the future. Waystar provides an intuitive claim management solution, enabling you to track and monitor claims through its life cycle. The vendor offers a three ring policy that ensures all claim-related calls are addressed within three rings, optimizing customer satisfaction.
It also lets you print e-claims and paper claims and increases the clean-claim rate with medical necessities and CCI edits. Receive ERAs from insurance payers and automatically post them into the system. By leveraging a robust relational database in a transaction-intensive environment, the Waystar platform facilitates highly efficient claim data routing. DrChrono EHR is a patient care platform that offers customization both at the point of care and on the go.
It provides claim management, scheduling, billing and patient reminder capabilities. This platform automates patient check-ins, triaging, clinical documentation, e-prescribing, lab orders, doctor referrals, billing and more.
The vendor offers excellent solutions for helping the medical insurance claims process. Preset billing profiles and single data entry for billing make your payment processing quick and simple.
Auto-generated forms help you speed up work operations and boost productivity. Use customizable templates to help save time. It lets you file electronic claims with the insurance payers listed in the solution directory. All patient information only needs to be entered once, and data will automatically sync to clinical charts, eRx, lab orders, billing and other EMR information.
You can improve the clean-claim rate and prevent human error occurrences. This medical claims management solution provides live feeds of submitted claims that help you filter claim records by various categories such as appointment profiles, billing statuses, rejected claims or denied ERAs. Kareo Billing provides excellent medical billing, scheduling, e-prescribing and claims processing functionalities. This billing solution can submit both primary and secondary claims to payers directly.
You can track claims through various stages of claim processing and get complete visibility. Our technology yields superior quality, lower costs and improved compliance. Unified on a single, cloud-hosted platform, Digital Now is a suite of solutions built to accelerate your digital transformation.
With rapidly deployable enterprise software and a team of experienced specialists behind you, you can do business better. Exela Smart Office is a suite of interconnected workplace technologies and services.
Find out how business process automation tools can enhance your employee and visitor experience, optimize space and energy usage, and streamline daily processes. A better way to manage health insurance claims. Omni-channel claims ingestion. Automated high-volume data capture and routing. Centralized communications. Efficient processing through clean claims enablement. Reduced resubmission and follow up.
Medical lockbox and e-payment integration. Overview Upgrade your claims processing by unifying data from all incoming communication channels, performing pre-submission checks to create clean claims, and intelligently routing claims for optimal processing using systems capable of intelligent decisioning. Explore the Benefits. Centralized Digital Gateway. Continuous System Improvement.
Improving auto-adjudication can drastically improve how quickly and precisely claims can be processed. Auto-adjudication is the process of paying or denying insurance and public benefits claims quickly without reviewing each claim manually. Auto-adjudication uses advanced AI software to scan for errors then match key details to make the decision of approval, denial, or a change to the claim automatically. It creates a seamless channel that is both paperless and humanless.
Internally there are multiple reasons which could prevent auto adjudication. Some adjudication platforms have limitations regarding accepting certain loops or segments carried in the EDI. In these cases, things such as primary payer adjustments, and other contractual PPO or bill review adjustments may cause claims to pending for review. Additionally, many procedures could be flagged by the payment system to ensure that medical necessity or prior approval was provided for the services.
Externally claims adjudication can be subject to even more causes such as billing errors, and mapping anomalies from downstream data sources. Billing errors can generally be detected upstream through standardized SNIP edits but each payer is unique regarding their provider relations, error management, and validation rules.
Additionally, factors such as name mismatches can also cause pends for many platforms. If a provider bills the claim as Jenny but the patient is on file is Jennifer, how does your platform handle that? A number of upfront validation checks such as member matching, provider matching, and business rules and edits can help improve auto-adjudication to handle those discrepancies. Pre-adjudication member matching can help reduce pends by normalizing disparities between proper names and nicknames of your members.
Additionally, this type of data validation and cleanup can resolve additional inconsistencies such as members being billed under their Social Security Number instead of their correct member ID.
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