Take the guesswork out of financial clearance and claims processing.
Automation is helping healthcare organizations decrease cost to collect and improve efficiencies throughout the entire revenue cycle from start to finish.
MedEvolve offers workflow automation solutions for both financial clearance and billing and collections.
Financial Clearance Automation
Financial clearance is the pre-registration process every practice should take in advance of a patient appointment. Prevent denials, rejections and write-offs on the back-end and ensure you get paid exactly what you are supposed to.
It involves checking the following key factors prior to the appointment:
- Insurance verification / COB
- Insurance benefit coverage
- Estimate patient liability
- Collect projected balance and prior balances (or deposit or CC on file)
- Demographic verification
- Check authorization requirements and secure
“We knew our front desk staff were making mistakes, but we didn't know how to resolve them because we couldn’t identify the problem areas. Now, our front-line staff feel empowered.”
Maryanne Thompson
Controller, MidLantic Urology
“They want to know if they missed something–if they forgot to check insurance for example. It is boosting staff morale and we’re constantly improving based on the data.”
Maryanne Thompson
Controller, MidLantic Urology
“We’ve already seen an 15% reduction in A/R and we anticipate additional long-term improvements as the machine learning algorithms continue to identify new opportunities.”
Jonathan Parisi
Director of Business Operations and Strategy,
Neurosurgeons of New Jersey
RCM Workflow Automation
Did you know of active claims require no immediate follow-up?
Why are billing representatives wasting time on them?
The answer is there is no visibility into which claims need to be focused on to generate revenue.
RCM Workflow Automation uses machine learning and artificial intelligence to assign claims to billing staff that will have the most return.
Protect your revenue cycle with RCM Workflow Automation:
- Monitor the status of every claim in accounts receivable (A/R) in real-time
- Understand which claims have been processed and which ones have not
- Know who each claim is assigned to in the billing office
- View staff productivity and optimize workflows from any location with an internet connection
- Gain full visibility into individual employee and department performance
- Use analytics to understand areas of process improvement
- Have complete accounting of all outstanding claims
Managing the revenue cycle continues to grow more complex, so it’s not surprising that even the most efficient administrative staff struggle to understand which claims need to be worked and when.
Gain easy access to answers to questions like:
- Are all claims on a worklist and assigned to a collector?
- What is the value of the AR my staff is working and are they prioritizing correctly?
- What is the cash opportunity?
- What is the status of my AR?
- When is my staff working and how effective are they?
“The system is like a GPS: representatives sit down, log into MedEvolve RCM Workflow, and hit go, and the system leads them.”
Jonathan Parisi
Director of Business Operations and Strategy, Neurosurgeons of New Jersey
“We’ve already seen an 15% reduction in A/R and we anticipate additional long-term improvements as the machine learning algorithms continue to identify new opportunities.”
Jonathan Parisi
Director of Business Operations and Strategy,
Neurosurgeons of New Jersey
Protect Your AR
- Carve out the claims that don’t require intervention “today”
- Design frontend denial worklists (COB/Eligibility, Auth, Registration etc.)
- Prioritize denied claims
- Focus on timely and appeal filing statutes
- Track all productivity and claim status on the AR
- Have complete accounting of all outstanding claims
- Use Analytics to provide feedback to the sites and business office on areas of process improvement
Easily find the answers to questions like:
- How are my staff doing today?
- Am I sure all claims are on a worklist and assigned to a collector?
- What is the value of the AR my staff is working and are they prioritizing correctly?
- What is the cash opportunity?
- What is the Status of my AR?
- How are my staff performing?
- When are my collectors working?
- How effective are my collectors?