Achieve A 99% Clean Claim Rate
Verify patient insurance upfront with one-click search.
Streamlined and efficient claims coding.
Send inaccurate or incomplete claims back for resolution.
Auto-code a trip based on NEMSIS data points.
Simplify claims coding and produce ready-to-bill claims with a one-click NEMSIS ePCR import, and achieve greater productivity with batch uploads of claims. Batch posting allows for the bulk upload of 835/ERA files into AdvanceClaim for one-click payment posting. This process also automatically streamlines the creation of your secondary, subsequent invoices.
Maintain accurate patient data with integrated partner technology, Accurint, a streamlined, point-of-need solution for investigating claims, patients and providers. Accurint searches LexisNexis® databases to access missing patient information or to verify patient demographics, providing you with all up-to-date patient data—from address, to social security number, to date of birth.
Automate and manage processes with AdvanceClaim's rules-based design, which provides the framework for system functions, from User Worklist Assignment, where managers can intelligently manage staff and assignments; to Automated PCS Processing, where the full PCS request-submission and billing workflow is automated; to AdvanceAuto-coding, where a trip is automatically coded based on NEMSIS data points, minimizing manpower and human error.
Sit back and relax while a trip is automatically coded. (The solution is ICD-10 compliant and programmed according to Medicare-defined rules that ensure payment on claims.) The trip is auto-imported into AdvanceClaim, which analyzes the NEMSIS data points upon which the coding is based, and then accordingly adds procedure codes for the determined level of service and mileage, along with additional medical necessity items. Simply review the results before submitting the "touch less claim" for processing. This feature minimizes manpower and human error.
Intelligently manage your staff and assignments with AdvanceClaim's User Worklist Assignment feature. It allows managers to quickly assign work to users, automatically routing the right claims to the right people. The feature enables staff to log into AdvanceClaim to view a list of claims assigned to him or her, and worklists are refreshed as new work is imported or assigned. This feature drives worklists for both the pre-bill and accounts receivable follow-up teams.
Get paid faster when AdvanceClaim's EDI tool scrubs your data to verify that the needed information is available to bill a claim to the respective payer. Designed to achieve a 99% clean-claim rate upon first submission, the tool optimizes clean claims, provides batch uploads, and tracks rejected claims, ultimately resulting in faster payment, often in half the time.
Seamlessly connect to 5,200 plus government and private payers via the EMS industry's first and only fully-integrated clearinghouse. Change Healthcare, serving as AdvanceClaim's clearinghouse, is the leading provider of revenue and payment cycle management connecting payers, providers, and patients within the U.S. healthcare system. The partnership makes it fast, simple and reliable to process your claims without ever leaving the AdvanceClaim system.
Bridge the communication gap between billing and operations of sending incomplete or inaccurate claims to operations for resolution. BTO automates the communication workflow, identifies the missing information necessary for billing, monetizes the impact of that missing information, and provides reportable metrics to increase accountability.
Instantly verify existing patient insurance by searching the region's top five payers for missing coverage information, and know that you'll get paid prior to claims submission with IntelligentEligibility.