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Claims
Processing
and
Editing
for Health
Plans,
TPAs,
Government
Payors
RevenueMD
understands
the
complex
issues
surrounding
payor
adjudication.
Minimizing
wasteful
time and
money
adjudicating
claims
with
errors is
critical
to the
efficiency
and bottom
line of
your
organization.
RevenueMD
is a
robust,
scalable,
high speed
yet
easy-to-implement
rules
engine
designed
to meet
the ever
changing
requirements
of your
environment
and the
healthcare
industry.
RevenueMD
837 Engine
Features:
-
All
industry
code
sets
and
procedures
–
CPT/HCPCS/ICD9,
diagnoses,
CCI,
LMRP,
revenue
codes,
DRG,
occurrence
codes,
value
codes,
treatment
codes,
etc.
– are
fully
supported
and
automatically
updated
as
revisions
are
announced
-
Edits
can
be
customized
on
any
field
to
meet
specific
needs
without
software
programming or
expensive
professional
services
-
Supports
837P
(professional),
837I
(institutional)
and
837D
(dental)
claims
-
Implemented
on a
local
server
or
via
ASP
allowing
fast
integration
-
Rules
engine
runs
at
blazing
speed
without
sacrificing
accuracy
RevenueMD
Advantages:
-
Rapidly
and
precisely
identify
and
eliminate
incorrect
and
incomplete
claims
before
they enter
adjudication
processing
-
Significantly
increase
first-pass
adjudication
rates
and
reduce
re-submissions
-
Decrease
suspense
processing
-
Decrease
false
accept
processing
and
losses
-
Provide
immediate
and
explicit
feedback
to
improve
provider
behavior
and
relations
-
focus
knowledge
workers
on
critical
business
activities
Automated
electronic
claims
submission
Efficient
claim
forwarding
and
routing is
one of the
most
crucial
functions
in the
healthcare
revenue
cycle.
RevenueMD
Submit
utilizes
connections
to most
commercial
and
government
payors to
ensure
fast and
comprehensive
EDI
submission
and
retrieval
of claims,
electronic
EOBs and
Remittance
Advices.
Available
to users
of our
RevenueMD
claim
editor,
RevenueMD
Submit is
integrated
to permit
submission
of claims
from the
RevenueMD
window.
RevenueMD
Submit
Features:
-
One-click
submission
of
“clean”
claims
when
used
with
RevenueMD™
-
Secure,
electronic
claims
submission
over
an
internet
connection
-
“All-payor”
solution
connects
to
most
commercial
and
government
payors
-
Automatic
data
formatting
for
every
supported
payor
-
RevenueMD-bundled
pricing
offers
cost
effective
alternative
to
other
clearing
services
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