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| ImpactMD ClaimEditor |
The Next Generation in Claims Editing and Scrubbing
Unfortunately, even when all published claim filing rules are followed, providers are still likely to encounter a high rate of unpredictable denials. ImpactMD has finally solved this mystery by developing a methodology that captures and catalogs the unpublished edits actually used by payers in claim adjudication. The advantages to this approach are extraordinary. Say goodbye to claims that are repeatedly submitted and denied for different reasons over many months. Within seconds the ImpactMD ClaimEditor reports every error in every claim needing correction. User friendly and automated, our Claim Editor can eliminate first pass denials! Imagine the benefit to your organization by using this predictive technology to correct claims before initial submission.
ClaimEditor Features:
- Millions of edits, almost half unpublished, cover most commercial and government payers
- Edits updated automatically every week
- Capability to eliminate denials of eligible claims
- Field-proven technology – tens of millions of claims scrubbed to date
- Automated one-click electronic claims submission.
You Can Expect:
- Accelerated cash flow
- Up to 20% reduction in receivables
- Up to 20% reduction in days in AR
- Lower costs to process claims
- Improved organizational work processes through denial analysis
Supported Edits:
- All seven WEDI/SNIP recommended levels
- Procedure coding to check for compliance with CCI policies, gender and age restrictions
- Medical necessity using CPT/ICD9 crosswalk data and the ordering of procedures for maximum reimbursement
- Diagnosis coding using valid primary diagnoses, proper levels of specificity and the inclusion and ordering of any required accompanying diagnoses
- Situational/conditional fields and service/procedure related fields are checked to see if they are required and reported
- Logical date-field relationships (e.g., date of onset occurs on or before date of service)
- Payer-specific published rules editing (Medicare, Medicaid, commercial carriers, etc.)
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Payer-specific unpublished rules editing
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Hospital Solutions |
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Improve revenue collection and predictability; reduce receivables and days outstanding ...
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Physician Solutions |
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ImpactMD offers physicians cost-effective, user-friendly solutions that can eliminate eligibility losses, minimize claims resubmissions and allow electronic routing to most payors.
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