At Experian Health's 2018 Financial Performance Summit, a client panel provides their best practice tips on claims and denials management.
Streamline claims management and to check that every claim is clean and error free before it is submitted, eliminating the costly, time-consuming need to redo them.
By integrating claims 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.
That means 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 needed modifications can be made and prepared for submission.
Analyze claims on a line-by-line basis with greater confidence and easily identify any possible errors well in advance of claims submission.
Intelligently exchange data with providers and payers. Clinical Data Clearinghouse moves key data among healthcare entities, using the intelligence and flexibility of its hub to overcome the issues which have been keeping the industry from achieving the goals of interoperability.
Ensure all claims are complete and accurate before submission to the appropriate payer or clearinghouse.
Manage claims, payments, denials—and prioritize high-impact accounts—for better efficiency and more revenue.
Improve cash flow by monitoring claim status early in the adjudication process.
Efficiently manage denials—and analyze remittance detail—to maximize payer reimbursement.
As a result of using Enhanced Claim Status, coupled with a few other products from Experian Health, this central Oregon group recognized a 15 percent reduction in both accounts receivable days and volume. The company additionally saw a decrease in denials and now tout a 92 percent primary clean claims rate.
A client panel discusses how they integrate Experian Health solutions into their Epic platform for more effective claims management.