Learn how Adeptia’s healthcare solutions provide seamless IT integration
and connectivity between multiple public entities, local agencies and central offices.
Enable seamless communication between patient, physician and managed care organizations by integrate billing and collection processes with clinic & hospital patient visit/admissions processes.
Seamlessly exchange common administrative and financial transactions such as health claims, enrollments, eligibility, payment & remittance advice, premium payments, health claim status, referral certifications and authorizations, and coordination of benefits.
Centralize all clinicals & patient accounting along with healthcare ancillaries such as lab, pharmacy & materials management. Guarantee compliance with Payer information requirements and reduce exposure to fraud, waste, abuse violations and regulatory compliance errors by utilizing structured documentation to capture and automate proper coding (DRG, CPT, ICD-10) at each patient encounter.
Create “clean” claims by matching billing to contractual requirements, calculating patient balances, editing/scrubbing final “encounter” billing, and enabling HIPAA validation on 837 Claim transactions.
Based on new CPT codes and newly published Medicare fee schedules, automatically initiate Charge Description Master maintenance processes.
Avoid denied claims due to administrative circumstances such as failure to secure authorization, failure to provide requested information, failure to verify coverage or insurance carrier delay tactics; or clinical issues such as medical necessity or relevance of care to contract.
Ensure that new processes and policies are efficiently followed throughout the provider organization by automating workflows. Free up IT and administrative staff to spend time on core concerns such as insuring swift receipt of revenues instead of spending time and effort on hold with payers and repeatedly keying in data on a payer’s website to check current claims status in the adjudication process.
Pull critical data and processes across the entire revenue cycle (e.g. scheduling, pre-registration, registration, care management, post-visit, patient management and collection management) processes.
Critical decision-making is easier by creating new views of the data. For example, perform outcomes reporting that ties payments and claims events to provide crucial knowledge about financial activity; produce staff productivity reports that alert management to bottlenecks and enable quick response to problem areas; and allow physicians, nurses and administration to see all the same data but from their specific views.