Pull bills and encounter information from EHR

EHR integration allows providers to fetch bills from multiple EHRs and healthcare platforms which need to be submitted for claims. Also, providers can create a new encounter in RCM by referring to a hard copy of patient encounter information.

Quick superbill creation with auto-populated encounter information

Superbill can be created by selecting a particular patient encounter. All encounter details will be auto-populated, and no need to re-enter detail. In addition to that, providers can create superbills manually by filling required details.

AI-based automated medical coding

AI-based automated coding will reduce ambiguity and improve the accuracy of the bill. ICD and CPT codes can be auto-populated by entering only the required description of the diagnosis and procedure.

Auto charge capturing reduces human errors

Providers can record their fee schedule for each service provided, referring to CPT codes. As the CPT codes are entered into the super bill system can auto-fill charges automatically from the appropriate fee schedule.

Taking the patient's finances into account

While generating the superbill, the system considers all the past dues and advances paid by the patient. It provides an estimate of the patient credits.

Cut down on provider efforts by attaching a document to a superbill

Providers and billers can cut back on the time they spend printing and shipping papers for claims and superbills.

Submission of claims with a single click and auto-fill

A specific patient encounter can be chosen to make a superbill.

You won't need to enter any encounter information again because it will all be automatically populated.

Additionally, providers can manually construct superbills by manually entering the required data.

Auto claim scrubbing reduces human errors

Before submission, automatic AI-based scrubbing will eliminate claim issues and lower the refusal rate. The scrubbing procedure allows for the verification of all spelling mistakes, medical codes, and costs.

Electronic claim submission, along with the paper claim

Providers can submit claims electronically directly into the payer portal. In addition to that offline paper claims like CMS1500 claim form can be downloaded and printed.

Online claims tracking and follow-up

A submitted claim can be tracked online by checking the claim status at the payer's end. In addition, the provider can take a follow-up through emails or calls for pending claims from the payer's end.

Secondary claim processing to get more reimbursed

If any patient is facing complications while submitting the primary claim, then the patient can apply for a secondary claim.

Actionable Deniel analysis and claim resubmission

Providers can view the rejected or denied claims and analyze it to find the root cause of rejection. They can take preventive action to reduce such claim denials.

Account receivable statistics with aging and follow-up

Providers can view the account receivable payment status with due age from the date of services. Providers can view the report and graphical form for better understanding.

A comprehensive analysis of the receivables assists in creating a strategy for payment collection

The analysis of account receivables by providers might reveal overdue payments and their causes. Based on the data, providers can create a strategy to stop payments from aging beyond due and enable early payment collection.

Auto reminders for due payment

Configurable reminders can be set to take follow-up of due payments from patients and payers. The system can automatically send an email notification to the payer and patient as per the configuration set.

Custom payment policy

Providers can set payment policies for each patient, like payment terms, mode of payment, and discounts. These policies can be modified as per customer needs.

Detailed Claim specific ERA payment posting

Providers can apply payments to each claim in detail per ERA payment advice provided by the payer.

Automatic EOB Posting

In an automatic EOB system, healthcare providers have immediate access to the EOB data required to communicate with payers regarding updated or rejected claims. It results in early revenue recognition for transactions.

Informative dashboard presenting revenue stats

The provider's dashboard shows various information like revenue statistics, claim details, and account receivables. Also, providers can view alerts and notifications for any upcoming tasks.

Essential performance reporting will help to analyze revenue gaps

Key performance indicators may be assessed by examining comprehensive reports based on revenue earned and claims submitted and reimbursed. This included ICD codes, CPT codes, Lab test sets, and much more.

Reporting in multiple formats like graphs, lists, and numbers

Providers can view reports in multiple formats like graphs, lists, and numbers, easily exported into the xls, pdf, and CSV formats.

Auto report generation and presentation to management

The system can generate reports automatically per configuration and auto-populate on the management dashboard or mail.

Configurable reports reduce repetitive efforts

Recurring use of these reports saves providers time spent searching and applying filters to receive results. Providers can configure their reports according to their needs and specifications and save the configuration.

Quickly export reports in XLS, PDF, and CSV formats

Providers may quickly and easily export their reports into the necessary file types, including PDF, XLS, and CSV. This will lessen the providers' efforts to repeatedly obtain reports.

Fetch patient information quickly from any EHR & EMR

The RCM system can integrate with any EHR and EMR to access patient information from multiple EHR and EMR platforms. Providers can directly fetch reports, encounter summaries, and patient balances from EHR/EMR.

Reduce daniel's rate by integrating with the clearinghouse

An RCM system will allow you to create an electronic claim and submit it to a clearinghouse. Clearinghouses receive and review the claims for accuracy, and then electronically transmit the claim data to insurance companies.

Payer integration for insurance verification and authorization

Payer integration leverages automation in electronic claim submission. It directly fetches into the payers portal, making it convenient to take follow-ups through auto reminders.

Integration with multiple payment gateways

Multiple third-party payment gateways are integrated into RCM. It advances payments from patients as a co-pay or self-pay.

Push claims to EHR seamlessly

Providers can push electronic or paper claims data and relevant payment information and follow up details to any integrated EHR. it can be synchronous and asynchronous way. This will help providers to keep track of their reimbursement status.

Secure Electronic claim transfer with HIPAA compliant standard

Since the electronic claim transfer is in XML format and the clearing house converts it to EDI format before sending it to the payers, it should be safeguarded via HIPAA compliant protocall.