BluePlanX
Our Insurance Discovery solution utilizes understanding of payer membership systems to locate high rates of active coverage for patients.
Benefits
- Leverages relationships built with 50 blue plans that are otherwise challenging to interact with unless a member ID is available to locate active coverage
- Utilizes claims data to enhance search options with 200+ payers to locate active coverage
- Triggers proprietary search mechanisms when the patient SSN or Medicare Beneficiary ID is not available to locate Medicare active coverage
Results
Our clients are consistently receiving active coverage results between 30% – 50% that enables efficient claim submission and timely reimbursement.
Xtended Claim Status
Our Claim Status solution leverages payer relationships to deliver rich claim adjudication data that improves operational performance.
Benefits
- Detects and corrects inaccurate patient and claim information to deliver the highest rate of successful claim status responses
- Accesses internal payer codes and translations to deliver rich claim adjudication data that enables touchless transactions while better preparing denial reps to resolve claims quickly
Results
A 20% – 25% improvement rate in receiving successful claim status responses; critical for avoiding costly & time consuming calls to payers.
Workers Comp & MVA Bill Status
The first bill status transaction for WC and MVA claims slashes inefficiencies like waiting for the EOB to be sent by fax and resolves the issue with an inverse relationship between the number of claims that are WC and MVA in an AR portfolio and the time to resolve those claims.
Benefits
- Automatically matches payer names and addresses to the correct payer IDs
- Eliminates manual research, spreadsheets, and guesswork
- Improves claim routing accuracy across all payers
- Integrates seamlessly into existing workflows and systems
- Reduces downstream denials caused by incorrect payer information
Results
- Faster claim processing and reimbursement
- Fewer denials and rework due to data errors
- Increased operational efficiency for billing teams
PayerMatch
Automated AI-driven payer name and address matching to the correct payer IDs to eliminate guesswork, improve claims accuracy, and speed up reimbursement.
Benefits
- Faster reimbursements
- Reduced administrative burden
- Improved transparency
- Enhanced compliance
- Increased revenue
Results
- 30% reduction in payment delays
- 50% time-savings on manual tasks
- 20% increase in revenue
VoiceX®
Our VoiceX solution eliminates dialing payers, responding to IVR prompts and waiting on hold.
Benefits
- Allows denial reps to be more productive working accounts by eliminating non-productive and frustrating time responding to payer IVR prompts and waiting on hold
- Transcripts of payer calls eliminate after call work while easily integrating with workflow and other systems
- Provides real time productivity reporting that indicates hold time saved per denial rep
Results
Denial reps make an additional 6 calls per day and increase the number of claims worked and resolved.
The success rate of our claim status responses was ~50% with a clearinghouse compared to ~80% with Integrex RCM