Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
Ensure a steady stream of revenue by utilizing a robust platform that accelerates reimbursements through eligibility verification, tracking claims status, conducting audits and appeals, and managing remittances for both government and commercial claims, all integrated into one cohesive system. Take advantage of a sophisticated rules engine that promptly cleanses claims in accordance with the latest CMS and commercial payer regulations, enabling you to rectify any inaccuracies prior to submission. During the claim upload process, confirm eligibility across all payers and identify any flagged issues, allowing for necessary edits before the claims are sent. Reduce the days in accounts receivable by implementing automated workflows for handling audit responses, submitting appeals, and tracking administrative dispute resolutions. Tailor staff workflow assignments based on the specific claim type and required actions. Additionally, automate the submission of secondary claims to prevent timely filing write-offs. Ultimately, enhance your claims revenue through automated workflows that facilitate quicker and more successful audits and appeals, ensuring your organization remains financially healthy. Furthermore, this comprehensive system can adapt to your evolving needs, providing long-term benefits as your operations grow.
Description
RCM Edge is an advanced revenue cycle management platform that harnesses the power of AI for medical billing entities, including physician practices, clinics, hospitals, and health systems. This platform streamlines billing processes from verifying eligibility to securing reimbursements and is compatible with current EHR and practice management systems. Edge Verify allows for immediate insurance eligibility and benefits verification through 566 payer connections. Meanwhile, Edge Claims monitors claim statuses over 468 payer connections, standardizes responses from payers, and directs claims that need follow-up into specific queues, enabling staff to concentrate on exceptional cases. By utilizing robotic process automation (RPA), predictive analytics, and real-time insights, the platform significantly minimizes manual labor for teams. Although features such as prior authorization, denial management, and accounts receivable follow-up are under development, they are not yet available as live modules. As a result, RCM Edge continuously evolves to enhance the efficiency of revenue cycle management in the healthcare sector.
API Access
Has API
No
API Access
Has API
No
Integrations
Inovalon Provider Cloud
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Pricing Details
$200/month
The Professional plan starts at $200 per month. A free 30-day trial is offered. Enterprise pricing is customized.
Free Trial
No
Free Version
Yes
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
Yes
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Customer Support
Business Hours
Yes
Live Rep (24/7)
Yes
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
Yes
Types of Training
Training Docs
Yes
Webinars
No
Live Training (Online)
Yes
In Person
No
Vendor Details
Company Name
Inovalon
Founded
1998
Country
United States
Website
www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-revenue-cycle-management/
Vendor Details
Company Name
ISpectra Technologies Global
Founded
2023
Country
United States
Website
rcmedge.ai/
Product Features
Insurance Claims Management
CRM
No
Claims tracking
No
Customer portal
No
Document management
No
EDI data exchange integrations
No
Electronic claims
No
Fraud management
No
Reporting
No
Product Features
Revenue Cycle Management
Accounts Receivable
No
Claims Management
No
Collections Management
No
EHR/EMR Integration
No
For Healthcare
No
ICD-10 Compliance
No
Insurance Verification
No
Medical Billing
No
Patient Portal
No
Patient Registration
No
Patient Scheduling
No
Payment Processing
No