When it comes to navigating claims, accountability and customer support are the keys to success. With the right workflow, extensive national and local payer edits, custom provider edits, automation tools, and outstanding customer support across the entire claims cycle, your team can prioritize high-impact accounts and efficiently manage getting your claims processed clean. The result? Smoother operations and increased revenue.
ClaimSource® ensures all hospital and physician claims are clean before submission to a government or commercial payer. The solution, fully scalable and web based, supports large multi-facility Centralized Business Office (CBO) environments, individual hospitals, or large physician practices by creating custom work queues for quick organization, easy prioritization of work and full accountability.
ClaimSource integrates ERA data directly with your internal accounting system and automates posting of claim payments and ERA data back into your host data system.
ClaimSource accesses insurance eligibility, patient demographics, payer compliance as well as claims and claim status from a single framework. It then automatically prioritizes the workload, so your staff can address the accounts in the order that makes the most financial sense.
This tool integrates seamlessly with Experian Health’s other solutions, including those used in the patient access and registration areas of your organization. You’re able to apply a national library of standard government and commercial payer specific policy edits to claims prior to submission, and individual provider edits can be created to accommodate your business needs.
ClaimSource also integrates ERA data directly with your internal accounting system and automates posting of claim payments and ERA data back into your host data system.
Are health plans complying with your contract terms? Verify the accuracy of payment received from third-party payers.
Denials Workflow Manager helps avoid payment delays and rework.
Enhanced Claim Status allows you to accelerate follow-up and improve cash flow.