Alternatives to RevCycle Engine

Service Center by Office Ally is trusted by more than 80,000 healthcare providers and health services organizations to help them take complete control of their revenue cycle. Service Center can verify patient eligibility and benefits, submit, correct, and check claims status online, and receive remittance advice. Accepting standard ANSI formats, data entry, and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers.

XpertCoding by XpertDox is an AI medical coding software that utilizes advanced artificial intelligence, machine learning, and natural language processing (NLP) to automatically code medical claims within 24 hours. This software streamlines and enhances the coding process, ensuring faster and more accurate claim submissions and maximizing financial returns for healthcare organizations. Features include a comprehensive coding audit trail, minimal need for human supervision, a clinical documentation improvement module, seamless integration with EHR systems, a business intelligence platform, a flexible cost structure, significant reduction in claim denials and coding costs, and risk-free implementation with no initial fee and a free first month. XpertCoding's automated coding software ensures timely payments for healthcare providers & organizations, accelerating the revenue cycle and allowing them to focus on patient care. Choose XpertCoding for reliable, efficient, and precise medical coding tailored to your practice.

Mercury One Plus is an intermediate billing solution for Medical Practice Management that provides the fundamentals of Revenue Cycle Management. It acts as a stepping-stone from standard billing to intermediate billing. Mercury One Plus is only available on the cloud. It offers the highest level security and you can access it anywhere, 24/7. Mercury One Plus is a complete product with a lot of functionality. It includes patient demographics inputter, 100 plus reports to choose from, charge input, full history patient activity, ERA posting and credit card acceptance, among other things. Mercury Products are HIPAA-compliant and have a connection guaranteed to any clearinghouse or insurer. Mercury One Plus will help you tune up your system daily with its automated job system. This includes: housecleaning, folder maintenance, daily backups, 837 exports and 835 imports. All subscriptions include expert support from CrisSoft.

RXNT's cloud-based, ambulatory healthcare software empowers medical practices and healthcare organizations of all sizes and most specialties to launch, succeed, and scale through innovative, data-backed, AI-powered software. Our integrated, ONC-certified healthcare software system—including Electronic Health Records, Practice Management, Medical Billing and RCM, E-Prescribing, Practice Scheduling, Patient Portal, and more—will streamline clinical outcomes, practice management, and revenue cycle management for your medical organization. RXNT is trusted by over 60 thousand providers and medical professionals across all 50 states in the U.S.A. to drive business growth, optimize operations, and improve the quality of patient care. All of our SaaS-based software products can be purchased standalone, but you can run you entire practice—from encounter to billing—with our unified Full Suite system. It utilizes a secure, central database so your data passes through every product in real-time from anywhere. Using our software, more than 125MM prescriptions have been transmitted and over $7B in claims have been processed. Our predictable, transparent subscription pricing model includes free setup & training, support, mobile apps, and more.

Audit Manager simplifies medical auditing by combining audit management, education, and reporting into a single web-based solution. Audit Manager was created by auditors for auditors. It allows you to audit on terms. You can access immediate reporting, customize templates, and have total control over your entire audit program. Audit Manager will increase your auditing efficiency up to 40%, reduce denials, and identify up to 10% missed revenue. Now included — Audit Manager features built-in Tableau integration to provide in-depth analytics and reporting.

Mercury Medical has been ranked among the Top 10 RCM and MPM solutions. It is a robust medical billing system. Mercury Medical offers over 400 customizable reports that can be customized, including a Scheduler and Patient Portal. This makes Mercury Medical a great solution for major billing. It is also suitable for multiple specialties and RCM processes. Mercury Medical is a proven professional Accounts Receivable solution. It will reduce processing times and payment cycles, increase cash flow, and improve cash flow. Mercury Medical can be configured to any vertical or process, including Anesthesiology and University, Physical Therapy, and many others. Mercury Products is HIPAA compliant and can be connected to any clearinghouse or insurer. Mercury Medical's automated job program will allow you to perform a daily system check-up. This includes folder maintenance, daily backups, and 837 exports and imports. All subscriptions include CrisSoft Support's expert assistance.

The eligibility checker ensures comprehensive verification of patients' financial eligibility, conducting insurance analyses and monitoring for inconsistencies. Should any inaccuracies arise in the submitted data, our advanced scrubber utilizes deep AI and machine learning algorithms to rectify issues, including coding mistakes and incomplete or incorrect financial details. This robust software currently boasts 3.5 million pre-loaded edits, enhancing its efficiency in error correction. Additionally, automatic updates from the clearing house are provided to keep stakeholders informed about the status of claims in progress. The system comprehensively addresses all aspects of billing, from confirming patient financial information to managing denied or lost claims, and features a thorough follow-up process for appeals. Moreover, our intuitive platform not only alerts users about potential claim denials but also implements corrective measures to avert issues, while maintaining the capability to track and appeal lost or rejected claims. Overall, this integrated approach ensures a smoother and more efficient claims management experience for healthcare providers.

Virtual Examiner®, PCG Software’s flagship product, monitors an organization's internal claims process to track provider data for fraudulent or abusive billing patterns and maximizes financial recovery. The Virtual Examiner®, a PCG Software product, allows healthcare organizations to improve their claims adjudication system by allowing for more than 31,000,000 edits per claim. The software monitors an organization's internal claim process to identify and reduce payments for incorrect or erroneous code to save premium dollars. Virtual Examiner®, is more than a claims management solution that focuses on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports.

Introducing the first-ever intelligent medical billing software that caters to multiple specialties. It simplifies the billing process and enhances patient collections for over 75,000 healthcare providers nationwide. With its global data capabilities, there's no longer a need for entering information multiple times. Designed to handle large volumes and intricate data, it features a flexible data structure that meets the diverse needs of various practices and specialties. This software ensures that you receive payments more quickly. You can input payments manually or utilize electronic remittance options. Claims are automatically scanned for errors and any missing details, ensuring accuracy. Additionally, the software can automatically resubmit insurance claims based on predetermined criteria. The rapid review feature allows for swift evaluation and approval of charges. You can audit charges by various metrics, including modality, procedure, insurance, user, or date of service. The intuitive reporting system provides insights into the financial well-being of both front-end and back-end billing processes. You’ll never miss a charge again. Furthermore, it seamlessly integrates with your chosen clearinghouse or statement vendor, making it a versatile choice for healthcare billing. With its user-friendly interface and comprehensive features, this software is set to transform the way medical billing is handled in practices.

Utilizing advanced automation for the processing of substantial amounts of medical claims allows businesses to achieve remarkable efficiency, transcending mere cost reduction. For those companies still dependent on manual methods, the handling of medical claims documentation and data becomes a tedious and error-filled endeavor, introducing unwarranted risks into the workflow. With Artsyl's ClaimAction medical claims processing software, organizations can enhance their profit margins, lessen the number of touch points involved, and eradicate processing delays. Capture essential medical claims data effortlessly, without the necessity for intricate software coding. Automatically direct claims information and documents to the appropriate examiner, adhering to your established business rules. Additionally, adjust intricate benefits and reimbursement guidelines to facilitate smoother processing and minimize payment holdups. This innovative solution also enables rapid responses to evolving government regulations, ensuring compliance across data, documentation, and procedural aspects, ultimately leading to a more robust operational framework.

Veradigm Payerpath offers a comprehensive suite of revenue cycle management solutions designed to enhance financial performance for healthcare organizations by improving communications with both payers and patients, ultimately increasing practice profitability across various specialties and sizes. By addressing issues such as incomplete information, incorrect coding, and data entry mistakes, the system ensures that claims are submitted cleanly and accurately. It also guarantees that claims are correctly coded, devoid of missing details, and free from errors before submission. With advanced analytical reporting, practices can benchmark their performance against state, national, and specialty peers, enabling them to optimize productivity and boost financial outcomes. Additionally, Veradigm Payerpath helps remind patients about their appointments while confirming their insurance coverage and benefits, streamlining the process. The platform further automates the billing and collection of patient responsibilities, making it easier for practices to manage finances. Notably, Veradigm Payerpath's integrated solutions are agnostic to practice management systems, ensuring seamless compatibility with all major PM platforms, which enhances its versatility in various healthcare settings. This flexibility allows practices to focus more on patient care while efficiently managing their financial operations.

Silna Health's Care Readiness Platform efficiently manages prior authorizations, benefit verifications, and insurance monitoring right from the start, ensuring that patients are ready to receive care while allowing providers to concentrate on delivering treatment. Powered by AI, the platform oversees the entire workflow of prior authorizations, which includes tracking future authorizations, sending weekly reminders, handling submissions, and conducting follow-ups, all while applying established industry rules and highlighting exceptions for human intervention when necessary. Benefit checks specific to various specialties confirm coverage, accumulation, authorization prerequisites, and visit limitations in real time, providing precise quotes at the point of intake. The system also performs continuous insurance monitoring to identify lost coverage, detect new insurance plans, and prevent eligibility gaps. Designed to operate without increasing staff numbers, Silna directly integrates data from EMRs and practice management systems, offers customizable rule sets and strategic frameworks, and features intuitive dashboards that present insights into incremental revenue. Overall, this comprehensive approach not only streamlines processes but also enhances the financial performance of healthcare providers.

E-COMB, or EDI Compatible Medical Billing, serves as a web-based platform designed to create medical claims that adhere to the HIPAA transaction and code set standards mandated by the US Government in accordance with the guidelines established by the American National Standards Institute (ANSI). This solution facilitates the generation, submission, and reconciliation of claims directed towards insurance companies, guarantors, and patients, making it an essential resource for healthcare providers to optimize their revenue by significantly shortening the claims reimbursement process. Additionally, all pertinent information related to the operational context of a Doctor’s Office or Hospital is compiled as Master Data, which is often utilized for claims processing and tends to remain stable over time. This Master Data encompasses critical details regarding Procedures, Diagnoses, Doctors, Payers, and Billing Providers, among others, and is initially created during the setup phase, with the flexibility for updates as necessary. Consequently, E-COMB not only streamlines the billing procedure but also ensures that healthcare professionals have easy access to the most current and relevant information for their operations.

Centauri Health Solutions is a company specializing in healthcare technology and services, motivated by our commitment to enhance the efficiency of the healthcare system for our clients while offering compassionate assistance to those in need. Our software, powered by advanced analytics, supports hospitals and health plans—including Medicare, Medicaid, Exchange, and Commercial sectors—in effectively managing their fluctuating revenue through a bespoke workflow platform. Moreover, our personalized support for patients and members grants them access to vital benefits that can significantly improve their quality of life. Our array of solutions encompasses Risk Adjustment (including Medical Record Retrieval, Medical Record Coding, Analytics, and RAPS/EDPS Submissions), management of HEDIS® and Stars Quality Programs, Clinical Data Exchange, Eligibility and Enrollment services, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, and both Referral Management & Analytics, as well as addressing Social Determinants of Health to further bolster healthcare outcomes and accessibility. Each of these components is designed to work in harmony, ultimately creating a more effective and compassionate healthcare experience for everyone involved.

Aptarro's HCC Coding Engine is a cutting-edge AI solution that works in harmony with electronic medical records and practice management systems, enabling real-time scanning of every patient interaction to automatically identify and rectify coding discrepancies, ensuring that all Hierarchical Condition Category (HCC) diagnoses are correctly recorded for effective risk adjustment and revenue optimization. Utilizing established industry rules and advanced machine learning algorithms, the engine highlights high-priority encounters for coder assessment, significantly enhancing coder productivity by as much as 300% without increasing the workload for providers, while simultaneously minimizing denials through instant validation and compliance enhancements. The system features exception-based workflows, user-friendly dashboards that track RAF score trends, integrated audit trails, and logging capabilities, and offers rapid deployment within current processes, allowing organizations to experience immediate returns on investment during their initial billing cycle and recover millions in overlooked revenue, all while upholding clinical focus and ensuring the integrity of documentation. This innovative approach not only streamlines the coding process but also empowers healthcare organizations to maximize their financial performance without compromising patient care.

If you are considering outsourcing your revenue cycle management functions, either entirely or partially, Precision Practice Management possesses the necessary experience and knowledge to assist you in navigating the ever-evolving challenges in this crucial field. They cover every facet of revenue cycle management, including compliance, credentialing, coding, claims processing, clearinghouse edits, electronic lockbox solutions, claim denial management, comprehensive reporting, and financial analysis among others. While your in-house team may excel in managing various aspects of medical billing, they also have numerous critical clinical responsibilities that demand their attention. Consequently, billing tasks might not always receive the focus they require, leading to potential shortcomings. Unlike your internal staff, Precision's dedicated medical billing specialists concentrate solely on billing, ensuring it is handled with the utmost expertise and efficiency. This focused approach allows your practice to thrive, as you can be confident that billing is in capable hands.

ARIA Coding Services is tailored to help healthcare providers manage the intricacies of medical coding effectively, guaranteeing precise documentation and prompt reimbursements. This service presents three adaptable tiers to cater to diverse practice requirements. Monthly assessments of coding denials and rejections are conducted by experts, who also suggest improvements to standard operating procedures and provide optional baseline evaluations for Evaluation and Management (E&M) documentation. Specialists meticulously review documentation to verify coding accuracy, scrutinizing superbills, invoices, claims, E&M visits, surgeries, procedures, tests, modifiers, and ICD-10 implementation. They compile regular reports to identify and resolve discrepancies, thereby refining coding practices. Furthermore, this all-encompassing service allows specialists to manage coding directly based on the documentation provided, ensuring the accurate entry of charges, comprehensive documentation within patient notes, and the rectification of any coding rejections or denials as necessary. Ultimately, ARIA Coding Services aims to streamline the coding process for healthcare providers, allowing them to focus more on patient care.

Effective collaboration in patient care hinges on continuous connectivity and access to the latest information. It has become increasingly crucial to streamline the exchange of this information with insurers. Availity simplifies the process of working with payers, guiding you from the initial verification of a patient's eligibility to the final resolution of reimbursements. Clinicians desire quick and straightforward access to health plan details. With Availity Essentials, a complimentary solution backed by health plans, providers can benefit from real-time data exchanges with numerous payers they frequently engage with. Additionally, Availity offers a premium option known as Availity Essentials Pro, which aims to improve revenue cycle performance, minimize claim denials, and secure patient payments more effectively. By relying on Availity as your trusted source for payer information, you can dedicate your attention to delivering quality patient care. Their electronic data interchange (EDI) clearinghouse and API solutions enable providers to seamlessly integrate HIPAA transactions along with other essential functionalities into their practice management systems, ultimately enhancing operational efficiency. This comprehensive approach ensures that healthcare providers can maintain focus on their primary mission: patient well-being.

Cut down on administrative expenses and enhance reimbursement rates, all while ensuring compliance is upheld. Transform your revenue cycle management (RCM) with the innovative capabilities of RapidClaims powered by AI technology. Significantly reduce administrative costs, elevate reimbursement levels, and maintain compliance with minimal effort. Simplify your coding workflow, and either automate tasks or empower your coding staff with tailored solutions that meet your specific needs. Process thousands of charts quickly and accurately while addressing the distinct demands of each client. Our advanced language model adeptly handles unstructured data, crafting a comprehensive patient record by turning notes into organized codes and identifying disease patterns. Avoid repeating past errors by establishing broad coding-related rules in straightforward language, which can be easily implemented across your charts, categorized by specialty, code type, and individual coders. Enhance your insight into code-level trends across various locations and take proactive steps to refine the revenue cycle. Additionally, our platform meticulously reviews charts to uncover claim denial trends, equipping you with the tools to address these challenges effectively and improve overall performance. With these capabilities, you can ensure a more streamlined and efficient coding process that supports your organization's financial health.

The process of patient access serves as the foundation for the entire revenue cycle management in healthcare. By ensuring that patient information is accurate from the outset, healthcare providers can minimize errors that often lead to additional work in administrative departments. A significant portion, between 10 to 20 percent, of a healthcare system's revenue is spent on addressing denied claims, with a staggering 30 to 50 percent of these denials originating from the initial patient access phase. Transitioning to an automated, data-oriented workflow not only mitigates the risk of claim denials but also enhances patient care access, thanks to features such as round-the-clock online scheduling options. Furthermore, patient access can be refined by streamlining billing processes through real-time eligibility checks, which provide patients with precise cost estimates during registration. Additionally, enhancing registration accuracy leads to greater staff efficiency, allowing for immediate rectification of discrepancies and errors, thereby preventing expensive claim denials and the need for further administrative corrections. Ultimately, focusing on these elements not only safeguards revenue but also elevates the overall patient experience.

Enhance your claims management process while reducing denials with superior edits and a top-tier clean claim rate. Healthcare organizations need advanced technology to ensure precise claim submissions and swift reimbursements. Claims Director, the claims management solution from SSI, simplifies billing procedures and offers transparency by assisting users throughout the entire electronic claim submission and reconciliation journey. As reimbursement criteria from payers undergo modifications, the system continuously tracks these changes and adapts accordingly. Furthermore, with an extensive array of edits across industry, payer, and provider levels, this solution empowers organizations to maximize their reimbursement efforts effectively. Ultimately, utilizing such a comprehensive tool can significantly improve financial outcomes for health systems.

Remittance360 is a valuable tool that can be leveraged by all entities within the healthcare revenue cycle industry. When organizations receive standard 835 files, staff members across various departments will benefit from this resource in making informed decisions related to cash flow and accounts receivable processes. The user-friendly nature of Remittance360 allows for a quick setup, with the 835 data upload process taking just a few seconds. By employing the standard 835 data set, organizations can effortlessly upload relevant information with very little need for IT support. This platform capitalizes on existing data to provide insightful reporting on denials, emerging trends, and activities of individual payers. Such insights are crucial for pinpointing specific workflow requirements. Additionally, users will find the data querying feature straightforward, and they can conveniently save common queries for future use. For instance, analyzing denials based on remark codes and departmental performance can help uncover and address underlying issues effectively. Ultimately, Remittance360 empowers organizations to enhance their revenue cycle management by enabling informed decision-making and targeted improvements.

The way you tackle the obstacles in your revenue cycle significantly influences your profitability and the overall effectiveness of your organization. The influx of patients seeking your services means little if receiving the payments for those services takes an excessive amount of time. You shouldn’t be burdened with dedicating countless hours to chase after payments that you rightfully deserve. Fortunately, there are more effective strategies to enhance healthcare reimbursement. Let Quadax assist you in developing a thorough, sustainable, and well-organized strategic plan while also helping you choose the most suitable technology solutions and services aligned with your business model. By partnering with us, you can not only attain operational efficiency but also improve your financial outcomes and elevate the patient experience. Ultimately, the aim for each claim submitted is to prevent denials and secure prompt payment. Additionally, implementing robust processes can further streamline operations and ensure financial stability for your organization.

A data-driven solution for managing claims and remittances specifically designed for healthcare providers looking to streamline their workflows, enhance resource efficiency, minimize denial rates, and expedite cash flow. Boost your initial claim acceptance rate significantly. Our all-inclusive edits package ensures you remain compliant with evolving payer guidelines and regulations. Increase your team's efficiency with user-friendly, exception-based workflows and automated procedures. Your personnel can conveniently utilize our adaptable, cloud-based platform from any device. Effectively manage your secondary claims volume through the automated creation of secondary claims and explanations of benefits (EOB) derived from the primary remittance advice. Leverage predictive artificial intelligence to identify and prioritize claims that require attention, allowing for quicker error resolution and minimizing denials before submission. Achieve a more efficient claims processing experience. Additionally, print and distribute primary paper claims, or compile and send collated claims along with EOBs for secondary submissions. This holistic approach not only enhances operational efficiency but also promotes better financial performance for healthcare providers.

Speed up payment processes while minimizing administrative tasks. With over 8,000 payer connections and established collaborations with more than 650 practice management vendors, our claims management solutions lead to a reduction in pending claims and decreased need for manual efforts. Efficiently and accurately send claims for various services, including professional, institutional, dental, and workers' compensation, ensuring prompt reimbursement. Tackle the evolving landscape of healthcare consumerism by delivering a smooth and transparent financial experience. Our patient engagement tools enable you to facilitate informed discussions around eligibility and financial obligations, while also lowering obstacles that could affect patient outcomes, ultimately fostering better healthcare experiences.

Utilize a cloud-based healthcare delivery system to effectively manage your members' healthcare and networks. This system streamlines the claims processing for managed care organizations by automating various tasks such as eligibility verification, referral and authorization handling, provider contracting, benefit management, auto adjudication of claims, capitation for primary care and specialty services, EOB/EFT check processing, as well as EDI transfers and reporting. It can be implemented as a cloud solution or operated in-house, making it suitable for a range of entities including managed care organizations (MCOs), independent physician associations (IPAs), third-party administrators (TPAs), preferred provider organizations (PPOs), and self-insured groups. By simplifying the intricate processes involved in managing eligibility, referral authorizations, and claims, this system enhances operational efficiency. Its features are designed to optimize data integrity while minimizing the need for manual data entry, thus improving overall accuracy and productivity. Additionally, the flexibility of deployment options ensures that organizations can choose the best fit for their operational needs.

iVECoder stands out as a vital coding tool empowered by the expertise of PCG's Virtual Examiner® claims review engine, a trusted resource in the healthcare industry for 25 years. This innovative tool allows users to input several codes and, with a single click, access numerous answers all on one page. By leveraging the same coding and billing intelligence platform utilized by payors, you can enhance coding precision and improve your financial outcomes. Essentially, iVECoder functions as an extension of PCG's Virtual Examiner® (VE) claims review engine, which boasts an impressive database of 45 million edits. Employed by healthcare payors across the United States and internationally, VE effectively guides payors on which claims to deny or hold for further evaluation. With iVECoder, healthcare providers can streamline their coding processes significantly.

EZDI is Acquired by AGS Health Company. Our revenue cycle management platform allows businesses of all sizes, large and small, to access our APIs and revenue cycle management platform to gain insights from their healthcare data. A platform that integrates medical coding and clinical documentation. Fully integrated platform that allows you to increase documentation and coding specialist productivity by upto 45%. It also increases revenue through improved case mix and risk scoring. Modern clinical APIs that seamlessly integrate into your infrastructure. To provide cutting-edge accuracy, we have been trained on more than 7,000,000 real clinical documents. We use millions of knowledge graph records, deep-learning, and machine learning to provide clear code suggestions and query suggestions. We are ready to lead the next wave in AI in healthcare. Built for coders, documentation specialists to work smarter, faster and more efficiently from the beginning. Our Deep Learning NLP models help the most brilliant minds in healthcare navigate a seaof data with confidence.

Upfront collection and cost estimates for patients. Instantly understand patient responsibility with automatic eligibility verification and benefit verification checks. Your practice data provides hyper-accurate estimates, which can lead to better care and a healthier company. Send estimates via email or text conforming to HIPAA. It's time for 2020 to be treated like 2020. Mobile patient payments upfront can help you collect more than ever. Reduce patient AR by getting rid of the write-offs

Computer-Assisted Coding, also known as medical coding, helps to boost productivity, make critical decisions quicker, and reduce denials, missed fees, and low-risk score. The AGS Computer Assisted Coding module (CAC) allows for flexible and scalable coding to increase accuracy, productivity, efficiency, and flexibility. Features: Integrated Encoder : CAC has a built-in, 'book-based encoder' that helps you select the correct code. It also includes full guideline information as well as coding clinics. Integrated References - An integrated reference guide contains detailed visuals and information on anatomy for coders during the coding procedure. Integrated and 3M grouper: DRG/MSDRG grouping comes built-in. For those who require the 3M APR grouper, it can be activated easily through an existing integration with third party (3M fees apply).

Amazing Charts Practice Management serves as an all-encompassing platform aimed at improving the workflow and operational efficiency of independent medical practices. Created by a physician with firsthand experience, this solution automates a variety of tasks, including the collection of patient demographics, appointment scheduling, and pre-registration of patients while verifying their insurance eligibility. Additionally, it generates insightful analytical reports and assesses patient financial obligations right at the point of care, while also managing insurance payer lists to facilitate timely and accurate billing processes. This aids practices in collecting payments more efficiently. Among its notable features are tools to monitor unpaid claims, a dedicated claims manager to analyze submissions and minimize denials, and an integrated secure connect clearinghouse that provides robust support and quick adjustments to changes from payers. Moreover, the system boasts intelligent, interactive dashboards tailored to specific roles, which automatically prioritize tasks across various departments, thereby enhancing overall productivity in the medical office. This comprehensive approach ensures that practices not only operate smoothly but also remain agile in responding to the evolving challenges in healthcare administration.

CombineHealth AI is the creator of Amy, Marc, Emily, and Diana, an innovative AI workforce engineered to support comprehensive Revenue Cycle and Practice Management services across healthcare organizations in the U.S. Powered by a proprietary foundational model, these AI employees provide an industry-leading 99.2% accuracy rate while maintaining 100% compliance with all coding and billing guidelines. The AI workforce effectively reduces coding mistakes, boosts coder efficiency, and helps resolve physician documentation issues. Organizations leveraging these solutions have seen a 35% uplift in clean claim submissions alongside a marked decrease in claim denials. The AI employees collaborate seamlessly with human teams to handle crucial tasks such as medical coding, billing, data entry, accounts receivable follow-up, and denial management. Beyond performing these functions, the AI provides transparent, auditable reasoning for every decision and action taken. This combination of accuracy, compliance, and accountability helps healthcare groups optimize revenue cycles and improve financial performance. CombineHealth AI is revolutionizing healthcare administration through intelligent automation.

Experience the advantages of seamless hosting and unique integrated features through a mobile OPIE platform, enhancing your practice management software. This essential tool is indispensable for every O&P business owner looking to monitor various trends, from patient satisfaction metrics to comprehensive financial reports. Gain valuable insights into the duration of patient care episodes while discovering strategies to minimize errors and optimize cash flow. Visualize each step of the payment procedure and delve into detailed information to refine your processes for insurance verification and authorization. By adhering to the OPIE Workflow, you establish a systematic approach to your operations, beginning with the collection of patient information and the specification of L-codes, extending through product ordering and the electronic submission of claims for billing. Ultimately, embracing this structured workflow not only enhances efficiency but also contributes significantly to overall practice management success.

ediLive! is a versatile claims processing solution compatible with any NSF, ANSI, or printed claim image, enabling HIPAA-compliant transmission of claim files from various practice management systems. Users of ediLive! enjoy the advantages of real-time connectivity along with efficient management of claim collections workflows. The software integrates all status messages from payers directly into the claim, simplifying follow-up and corrections while consolidating incomplete claims into a single, easily navigable worksheet for quick edits and resubmissions. For those utilizing ediLive!, we also offer a remarkable tool called the claims scrubber, designed to expedite and enhance the payment process for your claims. We invite you to contact our office for a complimentary online demonstration, during which we can scrub the first 100 claims for free as a trial. Remember, every coding mistake can lead to financial losses for your practice, so take advantage of this opportunity to optimize your claims processing.

Revenue cycle management plays a crucial role in the success of medical service operations, serving as a fundamental pillar for their sustainability. Essential tasks such as controlling expenses, boosting efficiency, and speeding up reimbursements are vital for the smooth operation of emergency medical services. However, navigating a claim through its entire lifecycle has often been a laborious process, frequently delayed by issues related to documentation and coding errors. ZOLL® Billing offers a cloud-based solution that significantly enhances billing effectiveness, allowing revenue cycle professionals to maximize financial returns. By streamlining workflows and reducing billing mistakes, ZOLL Billing empowers users to handle a greater volume of claims while minimizing resource expenditure, all while addressing compliance risks. With automated workflows, you can improve productivity and revenue, enabling your team to process an increased number of claims seamlessly. This innovative approach not only simplifies the billing process but also positions your agency for greater financial success in the competitive healthcare landscape.

Safeguard the reliability of your health plan while pinpointing precise pricing with the Context4 Health Plans Suite, our versatile and cloud-centric technological framework. Experience immediate and actionable insights for detecting Fraud, Waste, and Abuse (FWA), developed by our skilled team of certified experts in clinical, dental, and health benefits. By leveraging accurate data and state-of-the-art cloud technology, we deliver a robust and defensible Medicare reference-based pricing (RBP) solution. Our platform comprises over 100 healthcare data sets, complemented by professional guidance to enhance operational efficiency and ensure regulatory compliance. Additionally, our sophisticated medical coding software is tailored to streamline claim submissions and reduce the likelihood of denials. Furthermore, the cloud-based Payment Integrity Platform harnesses our unique analytics engine to uncover coding mistakes, assess medical necessity, address unbundling, detect fraud, waste, and abuse, evaluate audit risks, and identify pricing discrepancies, all of which can significantly influence your organization's performance. This comprehensive approach not only safeguards your financial health but also positions you for sustainable success in the ever-evolving healthcare landscape.

The LigoLab LIS & RCM Laboratory Operating Platform™, a comprehensive enterprise-grade platform, includes modules for AP and CP, MDx and RCM. It also supports Direct-to-Consumer. This allows laboratories to be more competitive in the marketplace, scale up their operations and become more profitable. The RCM module integrates with the LIS and automates ICD/CPT coding. The billing process begins at order inception and includes verification, eligibility and scrubbing components. This increases claim submissions and revenue and decreases claim denials. TestDirectly is a portal for patient engagement that allows labs and collection facilities scale collection, testing, reporting, and reporting workflows. This reduces friction and eliminates errors that can be caused by manual labor and paper forms.

Thoughtful AI presents an all-encompassing, AI-powered approach to managing healthcare revenue cycles (RCM). Featuring advanced AI agents like EVA for verifying eligibility and CAM for handling claims, this platform streamlines even the most intricate and labor-intensive RCM tasks. Aimed at enhancing both efficiency and precision, it lowers operational costs, decreases denial rates, and speeds up the posting of payments. Endorsed by top healthcare organizations, Thoughtful AI ensures smooth integration, promises a return on investment, and effectively cuts down costs associated with collections, all while adhering to HIPAA-compliant security standards and offering performance-based assurances. This innovative solution is transforming the way healthcare providers manage their financial processes.

Revolutionizing medical coding and auditing through artificial intelligence, our platform enhances the efficiency of manual inpatient coding processes, elevates the quality of documentation, and empowers your team to concentrate on more valuable tasks. Leading hospitals are experiencing significant advancements thanks to Semantic Health’s innovative solutions. By leveraging bespoke clinical AI and natural language processing algorithms, developed from millions of medical records by our exceptional AI experts, we can analyze clinical and coded data with precision. This enables our coding and auditing systems to grasp intricate clinical contexts, adapt to evolving coding guidelines, and identify high-quality coding and auditing prospects, all supported by clear evidence from clinical documentation. By integrating AI into the traditionally labor-intensive processes of medical coding and auditing, you can save time and enhance your revenue cycle. Furthermore, Semantic Health provides hospitals and healthcare systems with a powerful inpatient auditing platform designed to conduct comprehensive pre-bill reviews of claims data, ensuring that every detail is meticulously checked before submission. Ultimately, this approach not only streamlines operations but also significantly reduces the risk of errors.

Alaffia utilizes an advanced AI-driven system to identify and address fraud, waste, and abuse within complex healthcare claims, aiming to avert and recuperate overpayments for both payers and employers. By spotting and rectifying inaccuracies in misbilled claims prior to any incorrect payments being processed, Alaffia not only helps recover funds but also aids in minimizing future financial losses. With the potential for overpayments on erroneous claims to amount to hundreds of dollars annually for each employee, collaborating with Alaffia can lead to significant cost savings. The Alaffia system works to identify and amend incorrectly billed claims, thereby reducing the chances of overpayments occurring. Our integration with your health plan or TPA is designed to be seamless, ensuring that there is no interruption in service for your members. We operate on a contingency basis, meaning you incur costs only when we successfully generate savings for you. Additionally, we take measures to guarantee that providers do not bill your employees for services that were never actually rendered, thus safeguarding your financial interests. Through our innovative approach, we strive to enhance the overall integrity of healthcare billing practices.

PerioVision stands out as an exceptional practice management solution tailored specifically for surgical periodontists. It is equipped with precise tools and in-depth reporting features necessary for delivering outstanding patient care while boosting profitability. Continuously evolving through user feedback and technological advancements, PerioVision enhances its offerings over time. The system provides extensive patient records and customizable charting options, allowing you to operate your practice in a manner that suits your unique style seamlessly. Furthermore, PerioVision significantly minimizes paper usage within your practice, thanks to its adaptable framework that permits the integration of various technologies to create a customized office environment. With its detailed reporting capabilities, you can effectively monitor and enhance referrals, production, collections, and other vital metrics. Transitioning to a digital format is effortless with PerioVision, as it seamlessly incorporates both medical and dental electronic health records (EHR) into a single cohesive system. Additionally, it facilitates easy cross-coding, enabling the use of both medical and dental codes for billing, insurance claims, and meticulous record-keeping. This comprehensive approach ensures that your practice not only stays organized but also thrives in an increasingly digital world.

Enhance your clinic's appointment management by gaining better insight into the schedule and provider availability. Seamlessly view and arrange appointments for multiple providers, rooms, or locations to maintain a consistent patient flow. Patients can be automatically invited to fill out their intake forms online, with customizable digital paperwork accessible via smartphones or personal devices. This information syncs directly to their patient charts, streamlining the process. Reduce the likelihood of no-shows by sending timely reminders through both email and text messages. Communication is simplified for patients and staff alike, allowing for confirmation or rescheduling through two-way text messaging. Effortlessly generate claims from patient notes alongside suggested ICD-10 codes, and submit them electronically after automatic scrubbing. Comprehensive services are available to oversee the entire billing cycle, ensuring smooth submission and payment collection. Additionally, create clear, defensible clinical notes quickly with documentation templates, assessment reports, and pre-populated patient information, making your workflow even more efficient. This holistic approach not only improves organization but also enhances patient engagement and satisfaction.

All-in-one solution for your medical practice. Cloud-based online electronic health records (EHRs) that allow you to create and manage patient records securely from your browser. You can create and manage patient appointments, schedule resources such as rooms, IV chairs, etc. Use a color-coded calendar. Patients can book appointments through your website and patient portal. Upload and store patient and practice documents such as consent forms, handouts, x-rays, etc. Go paperless. To make it easy to find documents, group them into folders and tag them. Securely exchange messages with your care team regarding your treatment. Patients will be able to access their medical records via portability. They can also allow secure access to a local specialist when they visit abroad. You can discuss complicated cases while sharing images/videos, without having to pull doctors from clinics or wards.

Benchmark PM transforms patient engagement, covering everything from initial intake to final encounter. Key features include streamlined patient onboarding, hassle-free appointment scheduling, customizable reminders, comprehensive reporting, and user-friendly dashboards. On the billing side, Benchmark PM offers integrated claims management, a connected clearinghouse, electronic billing, insurance verification, and a versatile payment portal, simplifying the entire process. Benchmark Solutions provides a complete management solution for healthcare practices with Benchmark EHR software, Benchmark PM software, and Benchmark RCM services. This robust electronic toolset streamlines daily operations, boosts revenue, and enhances the patient experience. Each component of the Benchmark Solutions' suite is modular, ensuring easy integration with your existing systems. With Benchmark Solutions, you can focus on delivering high-quality care while we take care of the operational and administrative aspects, ensuring your practice runs smoothly and efficiently.

"I-Med Claims is a leading provider of comprehensive medical billing and revenue cycle management (RCM) solutions, trusted by healthcare practices across the United States. Our services cover every aspect of the RCM process, from eligibility verification to denial management, helping practices streamline their operations, reduce overhead costs, and maximize reimbursements. With flexible and affordable billing plans starting at just 2.95% of monthly collections, we deliver cost-effective solutions that ensure smooth financial workflows while maintaining high standards of accuracy and compliance. Outsourcing your medical billing to I-Med Claims can significantly boost your practice's efficiency by reducing claim denials and refusals, while increasing reimbursements. Our team of experts handles all billing tasks, allowing you to focus more on patient care. From compiling detailed billing reports to managing claims, we take the complexity out of the process, ensuring faster payments and better revenue management for your practice."