Revenue Performance Advisor Eligibility solution helps reduce eligibility-based denials and the subsequent costs incurred by reworking those denials. It also helps reduce bad-debt write-offs from bills for uncovered services that go unpaid. Use the solution to create batch requests or real time requests to 2,200+ payer connections at the point of service or use the easy-to-code API that integrates with your EHR. The API can be automated to deliver a continuous stream of real-time responses and to update the practice’s patient files in bulk. Responses are also stored in our solution for additional workflow tasking or reporting.
Claims & ERA
Claims that are validated and scrubbed before submission typically get paid faster. Revenue Performance Advisor provides an easy-to-use Claims Management solution that includes Medical Necessity and Correct Coding Initiative (CCI) edits. This helps you get claims right on first pass, enabling you to avoid timely and costly resubmissions. You’ll have increased visibility into the entire process, making it easier and faster to get the job done.
Revenue Performance Advisor offers clear, concise patient statements that help you collect patient responsibility and improve revenue performance. Easy-to-read statements that educate patients on their financial responsibility increase the chances of higher payment and fewer customer service calls.
Advanced Denial Management
The rejections and denials solution within Revenue Performance Advisor is designed to improve performance by automating your rejected and denied claims process and help increase staff efficiency and accuracy. Your staff can work by exception, so they can quickly spot any rejections, and validate and resubmit within minutes. Our in-depth drilling/exporting functionality allows for critical analysis of denials.
Revenue Performance Advisor helps you get claims right on first pass, enabling you to avoid timely and costly resubmissions. You’ll have increased visibility into the entire process, making it easier and faster to get the job done. Paper claim fees are based on usage.
Revenue Performance Advisor streamlines your practice’s workflow by enabling your staff to attach documents from right within the solution, including Workers Compensation and Medical Claims. Users simply pick the document, associate it with the claim, and send it to the payer electronically— or, for payers who don’t accept digital attachments, Change Healthcare will fax or mail.
Revenue Performance Advisor Denial Prevention employs artificial intelligence and machine learning to a practice’s historical remittance data to predict which claims are likely to be denied before they are submitted to the payer. Once those claims have been identified, they are flagged to let staff know there is an issue and added to the claim history, along with any associated rejections. This helps reduce denials, optimize claims submissions, and provide actionable insights to help you better identify and mitigate potential denials before they happen.
Revenue Performance Advisor Benchmark Analytics provides near real-time, end-to-end visibility into processes and trends that impact your practice performance. This greater level of insight helps optimize productivity, billing, patients’ experiences, and your bottom line. Benchmark Analytics features more than 40 reports that track dozens of KPIs. Each report links to claim-level data to easily identify root causes or to fine-tune front and back-office processes. Benchmark Analytics measures performance throughout the revenue cycle, including clearinghouses, payers, peers, reimbursements, patient payments, and your practice.