With higher deductibles than ever before and therefore larger patient co-pays, clearing self-pay patients is more challenging and labor intensive than in the past. Most important, earned revenue walks out the door every day when patients leave the office without paying.
Our Insurance Discovery tool combines innovative technology with human intelligence to explore every coverage option and payer source for patients presenting as self-pay. Using the latest mapping logic for more than 2,000 payers, clearinghouse databases and direct connections infrastructure, we find more active coverage for you.
Faulty patient demographic data is the primary reason for denied claims and failed insurance eligibility. Using our innovative Demographic Verifier tool, you can easily obtain complete and accurate patient information instantly, for every patient and every claim.
ZOLL AR Boost’s up-front, expansive patient data improves statement delivery, reduces the cost of claims and accelerates payments. The result is a stronger bottom line for your business.
Claim rejections and payment delays are tedious, time-consuming and inefficient, but it doesn’t have to be that way. Whether in real time or batch processing, your ability to access details regarding coverage by service type, co-pay, deductibles and benefits empowers better reimbursement.
Our Insurance Verifier tool combines technology innovations with receivables expertise to rapidly and accurately triage your patients’ insurance coverage. We solve your insurance verification and eligibility issues for every patient, every payer — every time.
Depending on the complexity of the prior authorization (PA) request, the level of manual work involved, and the requirements stipulated by the payer, PA can take anywhere from one day to one month to process. Delaying treatment can cause problems for patients and forces clinicians and administrative staff to divert attention from patient care to chasing down answers. Fortunately, there’s a better way.
Our Prior Authorization tool accelerates the process from provider order through PA adjudication, saving valuable time and freeing up your staff to focus on higher-value activities. In addition, it mitigates the risk of manual data entry errors, provides price transparency to providers and patients, and shortens turnaround time.
Patient responsibility is at an all-time high. On top of this, patients today expect personalized healthcare and an overall positive experience.
Our Self-pay Analyzer tool determines which patients are most likely to pay and pinpoints those who qualify for a hardship discount or Medicaid. Maximize internal collections and prevent low-hanging fruit from being outsourced to collections vendors by giving your AR the ZOLL Data Systems boost.
In recent years, the rise in patient cost sharing and deductibles have been a growing contributor to providers taking on bad debt. Our Deductible Monitoring tool equips health care systems and providers with real-time intelligence around a patient’s deductible fulfillment. This allows revenue cycle professionals to drop claims with surgical precision increasing the likelihood of receiving proper reimbursement while reduce self-pay collections costs.
One of the most challenging aspects of revenue cycle management is getting visibility into claim status at the payer. Often, only the highest priority claims receive attention, leaving revenue on the table due to lack of resources to run claim status checks and follow up where necessary.
Our Claims Monitoring tool automatically runs status checks and provides insight into claim progress upon acceptance into the payer’s adjudication system. It helps reduce the time and resources needed to run manual status checks and follow up on claims. Staff is freed up to focus their attention where it matters most: on collections and appeals.
Keeping tabs on claim status and following up on denials is a time-consuming, manual process. Lack of notification about and reasons for claim denials increase the time it takes to process a claim, as does the inability to send claims through the system multiple times per day.
Our Clearinghouse Services dramatically reduce rejections of first-time claims, thanks to robust claim scrubbers that help you achieve up to a 99% (or higher) clean claims rate. Intelligent routing and frequent payer synchronization enable same-day delivery, outpacing typical clearinghouses. Messages, rejects, and remits are instantly placed back in the work queue, always matched to the appropriate claim. When a claim is rejected or denied, fast, clear correction guidance helps you quickly rectify and resubmit the claim. Claim status is visible from submission through reimbursement. Our Clearinghouse Services streamline workflows and enable you to more effectively manage claims through their entire lifecycle, translating into a less time spent in AR and a faster time to cash. Learn more.