Aged Claims & Denials Management

• A daily process ensures patient tech staff are notified at the earliest time possible when further action is required for the claim to be paid.
• The automation of this tool will bring back and display to assigned staff the entire claim message posted on the payer’s web site. Based on the contents the message AutoMate AR will filter out all claims which require no further action as well as route claims that do require further action along with the message to the appropriate facility staff member for follow-up work.
• Cost-effective, streamlined process for the all Aged Claim Follow-up and Denial issues.
• Identifies root causes for denied charges and quantifies the claims denial problem.
• Reduces all denied charges upon the day that they are received.
• Assists in efficient re-bill of all collectible, denied charges as soon as they are identified, and reduce A/R days.

• Single, reliable source that provides the ability to verify a patient’s medical, dental and vision insurance in real time through an online web portal/access point.
• Completes payer eligibility verification for patient’s insurance and health care benefits with easy-to- read, customizable online graphs and reports, for managers and staff so they can access up-to-the- minute Web based data, then download it into Excel format for immediate and long-term use.

• Special Features Include:

• Retro-Review - provides a review and identification of prior closed claims, up to one year back that were actually billable, allowing the facility to capture lost revenues. **These searches are limited within timely filing deadlines per payer.
• Discovery Review - provides a “fishing” element when Medicaid coverage cannot be found, and automatically goes out to identify any other coverages the patient may have to increase the potential for billable claims.