Solutions
Insurance Discovery
Our Insurance Discovery solution utilizes understanding of payer membership systems to locate high rates of active coverage for patients.
Benefits
- Leverages relationships built with 40 blue plans that are otherwise challenging to interact with unless a member ID is available to locate active coverage
- Utilizes claims data to enhance search options with 200+ payers to locate active coverage
- Triggers proprietary search mechanisms when the patient SSN or Medicare Beneficiary ID is not available to locate Medicare active coverage
Results
Our clients are consistently receiving active coverage results between 30% – 50% that enables efficient claim submission and timely reimbursement.
Claim Status
Our Claim Status solution leverages payer relationships to deliver rich claim adjudication data that improves operational performance.
Benefits
- Detects and corrects inaccurate patient and claim information todeliver the highest rate of successful claim status responses
- Accesses internal payer codes and translations to deliver rich claim adjudication data that enables touchless transactions while better preparing denial reps to resolve claims quickly
Results
A 20% – 25% improvement rate in receiving successful claim status responses; critical for avoiding costly & time consuming calls to payers.
VoiceX®
Our VoiceX solution eliminates dialing payers, responding to IVR prompts and waiting on hold.
Benefits
- Allows denial reps to be more productive working accounts by eliminating non-productive and frustrating time responding to payer IVR prompts and waiting on hold
- Transcripts of payer calls eliminate after call work while easily integrating with workflow and other systems
- Provides real time productivity reporting that indicates hold time saved per denial rep
Results
Denial reps make an additional 6 calls per day and increase the number of claims worked and resolved.
Insurance Discovery
Claim Status
VoiceX
What Our
Clients
Are
Saying
“We have not seen anywhere near 50% active coverage rates in our pathology business”
“The success rate of our claim status responses was ~50% with a clearinghouse compared to ~80% with Integrex RCM"
“VoiceX eliminates the frustration of having to wait on hold for payers"
What Our
Clients
Are
Saying
Insurance Discovery
“We have not seen anywhere near 50% active coverage rates in our pathology business”
Claim Status
“The success rate of our claim status responses was ~50% with a clearinghouse compared to ~80% with Integrex RCM"
VoiceX
“VoiceX eliminates the frustration of having to wait on hold for payers”
Insurance Discovery
Our Insurance Discovery solution utilizes understanding of payer membership systems to locate high rates of active coverage for patients.
Benefits
- Leverages relationships built with 40 blue plans that are otherwise challenging to interact with unless a member ID is available to locate active coverage
- Utilizes claims data to enhance search options with 200+ payers to locate active coverage
- Triggers proprietary search mechanisms when the patient SSN or Medicare Beneficiary ID is not available to locate Medicare active coverage
Results
Our clients are consistently receiving active coverage results between 30% – 50% that enables efficient claim submission and timely reimbursement.
Claim Status
Our Claim Status solution leverages payer relationships to deliver rich claim adjudication data that improves operational performance.
Benefits
- Detects and corrects inaccurate patient and claim information todeliver the highest rate of successful claim status responses
- Accesses internal payer codes and translations to deliver rich claim adjudication data that enables touchless transactions while better preparing denial reps to resolve claims quickly
Results
A 20% – 25% improvement rate in receiving successful claim status responses; critical for avoiding costly & time consuming calls to payers.
VoiceX
Our VoiceX solution eliminates dialing payers, responding to IVR prompts and waiting on hold.
Benefits
- Allows denial reps to be more productive working accounts by eliminating non-productive and frustrating time responding to payer IVR prompts and waiting on hold
- Transcripts of payer calls eliminate after call work while easily integrating with workflow and other systems
- Provides real time productivity reporting that indicates hold time saved per denial rep
Results
Denial reps make an additional 6 calls per day and increase the number of claims worked and resolved.
