Handling claims is a key business process for a medical professional as well as any managed healthcare setup. It is proved that claims management consumes majority of time resources. According to some recent studies, the processing cost of a claim that adjudicates on the first pass (60–70 percent of claims) is pennies compared to dollars for a manually processed claim resulting from an exception or "pended" from the core system (30–40 percent of claims).
The electronic claims processing system aims at reducing the time spent in processing the data, improving the rate of claims reimbursement at reduced time limits, providing more time resources to the professionals, improvement in the quality of service and patient safety, reduction in administrative costs and improving the revenue for the practice / hospital.
Not all claims processing systems are same, they differ in capabilities. Hence, one needs to be very careful when selecting a particular claims processing system. At first, one should look into the requirements of the practice and then compare it with the features offered by the product:
Features That an Advanced Claims Processing System Must Offer:
• Instant verification of benefit and eligibility information
• Access to most payer connections in the industry
• Corrected and verified patient information
• Low Cost Claim Processing - No charge for transmission of commercial claims
• Flexible Claims Submission - Direct transmission or print-image
• HIPAA Compliant Solution - Claimat's working format is ANSI X12 HIPAA v4010A
• Unique Features - Claim Editor, Reimbursement Manager, Comprehensive Reports
• Electronic Medical Records (EMR)
• Online Prescriptions
• Simple, reliable online patient scheduling solution
• Data Analysis, Pay for Performance, HEDIS, and HCC reporting in real time
• Integrated tools will allow for the transmission of lab results to patients, medical groups and health plans
• Integrates crucial pharmacy data with convenience and clarity
The electronic claims processing system aims at reducing the time spent in processing the data, improving the rate of claims reimbursement at reduced time limits, providing more time resources to the professionals, improvement in the quality of service and patient safety, reduction in administrative costs and improving the revenue for the practice / hospital.
Not all claims processing systems are same, they differ in capabilities. Hence, one needs to be very careful when selecting a particular claims processing system. At first, one should look into the requirements of the practice and then compare it with the features offered by the product:
Features That an Advanced Claims Processing System Must Offer:
• Instant verification of benefit and eligibility information
• Access to most payer connections in the industry
• Corrected and verified patient information
• Low Cost Claim Processing - No charge for transmission of commercial claims
• Flexible Claims Submission - Direct transmission or print-image
• HIPAA Compliant Solution - Claimat's working format is ANSI X12 HIPAA v4010A
• Unique Features - Claim Editor, Reimbursement Manager, Comprehensive Reports
• Electronic Medical Records (EMR)
• Online Prescriptions
• Simple, reliable online patient scheduling solution
• Data Analysis, Pay for Performance, HEDIS, and HCC reporting in real time
• Integrated tools will allow for the transmission of lab results to patients, medical groups and health plans
• Integrates crucial pharmacy data with convenience and clarity
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