Exception based workflow

Adopting an exception-based workflow substantially improves an organization’s revenue cycle operations. When coding and billing processes are automated using logic and rules, there is a marked decrease in human error. The end result is a re-configured workflow where individuals and their expertise are called upon only when needed, by exception, enabling faster time-to-bill.

Communication

An embedded messaging system enables coding and business office staff to communicate with providers in order to solve coding errors and questions proactively.

  • An effective tool to alert providers about missing charges
  • Supports near-time issue resolution to reduce inherent lag
  • Helps busy providers stay connected with their revenue team

Revenue Transparency

With our real-time reconciliation dashboard, revenue teams have immediate transparency into the status of every status expected for the day, visit or admission.

  • Shows missing and/or late charge status at a glance
  • Eases the process of month end closing and timely claim filing
  • Enables rapid provider engagement to maintain revenue wholeness

Embedded Compliance Support

A real-time coding compliance engine that relies on millions of alphabet soup rules to help business offices prevent errors prior to claim creation and submission.

  • Rules can be configured down to the specialty and end-user profile 
  • Problematic charges can be held or escalated for review and resolution
  • Comprehensive reporting lets groups understand habitual coding errors and patterns

Custom Rules Capability

Adjunct custom rules functionality that complements a very robust standard rules engine to address local payer issues.

  • Ideal to apply based on downstream denials data and ongoing performance improvement
  • No limit to the number of alerts that can be created, applies and modified
  • Helpful with rural health centers, experimental treatments, modifier exceptions and more

Configurable Queues

Digital work queues let coding and billing team members escalate charge review and auditing seamlessly.

  • Charges route to supervisors based on meeting trigger criteria
  • Helpful when complex charges such as multiple procedures or critical care time require review
  • The faster charges are reviewed, the faster bills will get out of the door

To learn more, watch the this webinar: Stop revenue leakage with medaptus – rules and queues

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