A data-agnostic tool has the ability of one system to work with many systems, rather than being designed for a single system. A system that is “data agnostic” can work with information received from heterogeneous databases, i.e. databases with dissimilar data formats.
This tool has an integrated facility with 17 different PMS including “EPIC”. The tool uses 837 and 835 data to categorize the denial. Then they use the specific option in the tool called DMA flow (Denial Management Analytics), in which the denial status by description and each denial scenario is categorized in graph, which is also customizable to our needs by payer, denial, total amount etc.
This is both a cloud-based and PMS integrated tool. It can be integrated with almost all PMS like Nextgen, AllScripts ECW, Kareo, and Epic Etc.
It has a feature where the tool is linked with payer databases and it obtains the claim information and categorises it according to the status whether paid, denied or patient’s responsibility. It reduces time consumption on obtaining claim information.
CARC and RARC codes are analyzed and then it is routed to a denial overview page were the denial overcome percentages are revealed using probability and payer regulation calculations
The action panel is then opened to enter notes, action description and status of the claim. Card view features were all the information of the patient and the claim is stored. We need not navigate from one PMS to another HER. The data obtained from the integration will suffice for denial action and management. Also they have a EPL engine which will determine how many days for follow up and will be automatically populated.
Workflow Management:
A workflow management option is inbuilt in this tool. The account receivable management team member’s information is first listed. Then each denial scenario is assigned to an associate who has expertise in dealing with a particular denial management scenario. Then the number of accounts assigned, resolved and not worked are all combined into a report of our choosing, graphs, pie charts, percentages etc.
Professional Services CBO:
This tool offers monitoring, training and managing the team’s performance. Time/attendance, Productivity and quality all can be monitored in one single CBO.
All reports are already pre-set. So no need of altering or manual work is required. Documents from client and payer are also uploadable in PDF formats.
