An early-and-often approach to monitoring claim status in the adjudication process is crucial for improving cash flow and maintaining a financially sound revenue cycle. Going beyond the ANSI 277, and using proprietary information from hundreds of payers nationwide, is key to long term profitability.
Enhanced Claim Status eliminates manual follow-up tasks and lets providers respond early and accurately to pended, returned-to-provider, denied, or zero-pay transactions before the Electronic Remittance Advice and Explanation of Benefits are processed. Automated and timely, Enhanced Claim Status submits status requests based on each payer’s adjudication timeframe, improving productivity and facilitating prompt and accurate payment.
Enhanced Claim Status lets providers respond quickly to denied, pending, returned-to-provider, or zero-pay transactions before the ERA/EOB is processed, providing a richer, more actionable data set.
Using Enhanced Claim Status allows you to decrease the manual intervention between your staff and payers by automatically generating work lists of claims with actionable data. Staff members can efficiently follow up on items needing attention, so you get more out of your team without adding FTEs.
Our solution enhances the regular ANSI 277 claim status response using proprietary information from hundreds of payers nationwide. This process reduces the need for staff to access the web for additional information and clarification.