Data requirements put forth by the government and payers continue to change, and maintaining practice management systems, claim formats, etc is more important than ever. Practices need to take advantage of clearinghouse and payer tools such as: on-line eligibility; electronic remittance; electronic funds transfers; patient portals; patient statement services; on-line explanations of benefits and payer denials. These are critical elements of a practice’s EDI capabilities and directly contribute to the overall efficiency of well-executed revenue cycle management.
Minimize the number of claim denials due to basic data fulfillment and format requirements.
Ensure claim formats are able to accommodate varying data as dictated by the different payers.
Connect to payers electronically – monitor and track claim acceptance, processing and payment dates.
Remove tedious, repetitive tasks from office staff and utilize automated processes to ensure consistency in execution while re-allocating staff time to more specialized responsibilities.