Clearing House and Claim Scrubber Development

e-Bill – workers comp / No Fault / PIP Claims

Get rid of paper billing, endless form-filling and mailroom workload. Optimize efficiency by submitting WC/NF/PIP claims electronically.

Claim Scrubber

Increase first pass rate up to 98%, automate billing processes and improve cash flow by eliminating errors before filling. Avoid front-end rejections and substantially eliminate denied ERA/EOB’s.

Paper Claim Printing & Electronic Medical Necessity Documentation Submission

Printing, postage and mailing HCFA 1500 and UB 04 to payers that require paper claims. Attach electronic necessity documentation for prompt adjudication.

Batch Claim Processing (ANSI 5010A1 837P and 837i)

Our claims processing helps you collect more in less time and effort. Our powerful claims scrubber monitors all claims and creates additional edits based on the rejection reasons, which increases the first- pass rate for all our users.

Remittance Management (5010A1 835)

  • Receive payments and supporting information more quickly
  • Automatically post ERA to practice management systems
  • Easy ERA denials received management
  • Seamless segregation of primary/secondary ERAs
  • Reduce/eliminate data entry errors
  • Monthly, weekly and daily payment tracking

Real Time and Batch Eligibility (5010A1 270-271)

One of the most common reasons for claim rejection or denial is ineligibility. Rather than putting reimbursement at risk after a patient encounter, your registration staff can use our services in either real-time or batch to determine patient insurance eligibility prior to rendering service.

  • Receive real-time access to critical patient and insurance information, including coverage dates,
    benefit ceilings, co-pays and more
  • Eliminate rejections and denials
  • Increase cash collections and profitability
  • Improve staff productivity – eliminate manual eligibility verification
  • Up-to-date co-pay, co-insurance and deductible information

Real Time Certification and Referral Inquiry and Request (5010A1 278):

Verify whether a service or prescription is covered by a patient’s health insurance company before providing service.

Real Time and Batch Claim Status (5010A1 276-277):

Checking claim status does not need to be time consuming. We offers electronic Claims Status to help streamline the process. It offers a quick and easy way to streamline your administrative tasks. Check claim status through a single click simply by logging into the portal and selecting the relevant claim.

How Does It Help?

  • Simple method to verify claim status
  • Increased productivity and efficiency
  • Less time spent on manual tasks
  • Decreased duplicate claim submissions

Revenue Cycle Management Portal

Analyze, measure and manage all aspects of your revenue cycle operations. Acquire valuable insights on key performance indicators, financial trends and more including:

  • KPI Dashboard
  • Claim Management
  • Trend analysis
  • Eligibility
  • Claim Status
  • Referral Inquiry and Request