Electronic Claims/Remittance

• Clearinghouse processing, routing, reconciliation
• Front-end and clearinghouse edits
• New payor set up 

All claims will be sent electronically unless paper claims are necessitated by the payor or claim specific requirements.  Claims are submitted daily.

Automated front-end edits, including customized client and payor edits, are used to identify claims which are likely to be denied by the payor. 

Claims are corrected prior to payor submission resulting in clean claims, quicker reimbursement and reduced days in accounts receivable.

For new payors, claim filing rules are incorporated into claim form logic and front end edits to ensure clean claims are filed.

Reports

• Denial management
• Detailed claim information
• Summary reports

Detailed edit/carrier status reports are available to assist in denial management or trending.

Custom reports drilled down to the CPT/payor level are available.

Monthly/quarterly summary reports available.