Healthcare Claims Management

Automate claims and improve reimbursements

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Summit Medical Group Oregon – BMC recognized a 15 percent reduction in both A/R days and volume. They also saw a decrease in denials and now tout a 92 percent primary clean claims rate.

Improve financial performance with automated, clean and data-driven medical claims management.

Automatically check that every claim is clean and error-free before it is submitted. Eliminate the costly, time-consuming rework typically associated with claims management. 

By integrating claims management software with customized edits into the workflow system, providers can thoroughly review every line of every encounter and verify that each claim is coded properly and contains the correct information before the claim is invoiced and submitted for reimbursement.

What does this mean for you? Encounters are processed in real time with automatic alerts that highlight incorrect codes or other potential issues before the claims submission. Responses include a detailed explanation of why a claim was flagged, so any necessary modifications can be made prior to submission. 

Analyze claims with greater confidence and easily identify any possible errors well in advance of claims submission. 

Data Driven Revenue Cycle

Analyzing financial and operational data to improve performance

Drive streamlined and accurate claims management

Optimize

Reduce claim denials, corrections and rebilling. Optimize reimbursement and improve first-time pass through rates. 

Prioritize

Execute the most effective workflow for your team and confidently prioritize high-impact accounts. 

Monitor

Improve productivity and cash flow with automatic claims status updates throughout the adjudication process. 

Analyze

Increase reimbursements with denial analysis and automation. Gain insight into root causes for denials and act fast. 

Claims management resources

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How to prevent and manage claim denials

For many healthcare providers, claim denials are a frustrating cost of doing business. Each year, around 5-10% of medical billing claims are rejected (possibly more). With each claim costing around $25 to rework, providers lose billions in eroded revenue and productivity.

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Four ways to use AI and automation in your revenue cycle

Artificial Intelligence (AI) and automation are the latest buzzwords in business innovation. But what exactly do they mean, and how can they help your healthcare organization?

healthcare worker wearing mask

Medicare MBI: COVID-19 and Medicare claims

At the beginning of the year, the healthcare industry moved away from Medicare identifiers based on Social Security Numbers (SSNs), in favor of more secure Medicare Beneficiary Identifiers (MBIs). As with any large-scale change program, the shift was unlikely to be completely clear sailing.

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How to avoid patient misidentification and claims denials

For many of the 36 million Americans who have registered for unemployment benefits during the coronavirus outbreak, losing their job means losing their health insurance. Options for the newly-unemployed are limited yet complicated.

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If you would like to talk to a representative immediately, please call us at

1 888 661 5657

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