Health Care

Clearing House

clearing House

   A Web-based medical claims clearinghouse that manages every aspect of the revenue cycle including claims management, eligibility and electronic remittance advice (ERAs).

Business situation:
   Our client is US healthcare physician. Client requires clearinghouse removes much of his burden by acting as a middleman between the provider and insurance companies. The provider gains a single point of contact, the clearinghouse, and a single way to process generic claims, through the clearinghouse, regardless of the insurance company

Solution:
   We provided solution called clearing house. Clearinghouse will give a huge impact on your business. The more efficiently clearinghouse processes and returns the information, the faster our client will get paid, and the more payments to collect.

Features:
   (i) Fully integrated Scheduler
   (ii) Mouse free operation
   (iii) Tab control
   (iv) Switch programs

Major enhancement:
   (i) Claim generation logic
   (ii) Revenue management
   (iii) Claim status with dates and info
   (iv) ERI posting
   (v) Eligibility verification
   (vi) Using major enhancement so practices can preview balance, post payment.

Benefits:
1. Quick Claim Responses (Claim Status)
   Once claims is submit, client should know within minutes which claims went through and which claims need to be fixed and resubmitted.
2. Consistency and Accountability with 835s
   sour client should receive an 835 and payment within a consistent timeframe so they can post and reconcile payments quickly. When they can count on receiving 835s and payments within a day or two of each other, we won't waste time tracking down delayed 835s or payments for posting and reconciliation.
3. Efficient Claim Information.
   For example, our clients can view a summary of all claim statuses on an 835, staff can immediately identify which payments to post and which claims to reprocess. Additionally, staff should have the ability to update the claim statuses as they reprocess claims or post payments, so they don't duplicate any work done on the 835. This enables them to track all claim activity from a summary report or dashboard without wasting time looking at each individual claim.

Usability:
   if our client can't easily train their staff to use our system, it won't benefit for them." Our clearinghouse mechanism is with easy-to-use features like human readable claim responses and 835s; detailed and customizable reports hosted in a secure, private cloud; and a minimal number of clicks required completing your workflow.

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