ThirtyDayClaimBreakOutWe provide a thirty day snapshot of claim activity broken out by paid, patient portion and denied/contractual obligation.

 

 

Search DenialWe provide the ability for patient accounting and informatics personnel to research specific combinations of line item denials by denial and / or charge code. This allows users to drill down into the actual claim detail to identify the specifics behind the denial of service on the same day it was received.

PaymentComparisonPieWe provide executive level view of the performance of a specific payer on a year over year basis. You can also compare the payment history of two different payers for the same period.

 

 

 

 

DenialTrendWe provide a comprehensive executive level overview of total denials on a monthly basis broken out by root cause, going back up to 2 years.

 

 

 

 

 

DenialRootPayerQVWe provide an executive level real-time overview of denial reasons or root causes by payer.

 

 

 

 

 

Denial TrendsQTRWe provide a rolling twelve month trending of denials by quarter, this allows the user to drill down into the claims to the supporting detail to find the root.

 

 

 

 

 

 

Denial KPIWe provide executive level trending data by denial source relative to Key Performance Indicators (KPI). KPI's are assigned by the user for individual payers by the source of the denial. The KPI is a key component or trigger for MedSpans Alert system. The alert system notifies the executive by email when denials exceed the users KPI or threshold amount, alerting them of interruptions in cash flow in real time.

 

 

 

ClaimWorkQueWe provide a complete list of individual claims as well as their disposition. Queues provide the basic work assignments for patient account representatives when utilizing the work flow product. Queues are typically assigned by payer such as Medicare, Medicaid, Blue Cross. Patient account representatives can filter and sort claims based on such things as claim amounts, claim disposition and status.

 

 

 

 

ClaimPaymentDenialQVWe provide executive level summaries of claim payment activity augmented with at a quick view of the types of denials recently encountered.

 

 

 

 

 

claim displayOur software creates a searchable electronic claim remittance or EOB (Explanation of Benefits). This displays the claim detail and specific reason why individual charges were denied. This is a patient accounting's primary view used to work or research denials.