Healthcare Claims Management
Ranked #1 Best in KLAS 2024 Claims Management and Clearinghouse
Reduce denials with automated claims management
Processing claims is one of the top contributors to “wasted” healthcare dollars in the U.S. The latest Experian Health survey reveals that 73% of respondents report a rise in claim denials, compared to 42% in 2022. Additionally, 67% of respondents have noted longer reimbursement times, reflecting a broader issue with payer policy changes and errors in claims. (Report: The State of Claims 2024)
See how our integrated products work together to automate your claims workflows and improve your healthcare claims management process.
- Accurately and quickly submit clean claims for reimbursement
- Decrease manual work through automation
- Eliminate costly, time-consuming rework
2024 State of Claims
Denials are on the rise.
This report, based on a survey of 210 healthcare professionals responsible for claims management, assessed the extent of denied claims, the causes, and the efforts to mitigate denials.
ClaimSource®
Increase productivity and expedite revenue by simplifying your claims editing and submission process.
Enhanced Claim Status
Accelerate claims follow-up by receiving an accurate adjudication status within 24–72 hours.
Denial Workflow Manager
Automate your denials process to maximize reimbursements and increase cash flows.
Community Medical Centers
Brandon Burnett, VP, Revenue Cycle at Community Medical Centers, shares how their organization took their long-time ClaimSource usage to the next level with AI Advantage™ to further inform denial prevention and to triage claim denials.
Summit Medical Group Oregon - BMC
How this central Oregon group worked used Enhanced Claim Status to decrease denials and achieve a 92% primary clean claims rate.
Frequently Asked Questions (FAQs)
Having a claims management solution is like having a claims expert on your team. It double-checks everything for missing info or incorrect codes prior to claim submission, preventing denials that waste time and money. Even better, our healthcare claims management solution continuously monitors payer policy changes, helping you put the right workflows in place to prevent denials before they happen. Streamlining this process means less time spent on paperwork and more time for what truly matters—providing excellent patient care the way it should be, face-to-face.
Imagine a world where you ditch the data entry struggle and multiple software juggling act! Integrated healthcare claims management is like having the ultimate all-in-one system. No more errors from duplicated entries, slow processing times or being in the dark about your claim’s status. A single, connected system gives you greater visibility into your claims. This way, you can catch problems and fix them fast, reducing denials and keeping your cash flow healthy.
The right medical claims management can be a real money saver. Fewer denials mean you get paid quicker, and your staff doesn't have to do double the work. Plus, it saves your team time by catching errors prior to submitting the claim to the payer for adjudication. It's like having a built-in watchdog for your coding and billing, finding ways to save you money in the long run. Streamlining the process means less time spent making corrections prior to claim submission.
Keeping up with healthcare regulations can feel like running a marathon. The right healthcare claims software can be your trusty running buddy. They're constantly on top of the latest regulations, with built-in checks to catch any red flags before you submit a claim.. Knowing you're compliant frees you up to focus on what matters most—delivering top-notch patient care.
Indiana University
How IU Health processed $632 million in claims transmissions in one week after halt to operations
Summit Medical Group Oregon - BMC
How this multispecialty health group reduced accounts receivable days by 15%.
Understanding healthcare claim denials: reasons & solutions
Experian Health’s State of Claims 2024 report reveals a worrying trend in healthcare claim denials, with nearly three-quarters of survey respondents reporting a rise.
Experian Health earns highest KLAS ranking in claims management
As the healthcare industry grapples with labor shortages, rising costs and increasingly denied claims, effective revenue cycle solutions that improve accuracy and efficiencies are more paramount than ever.
6 steps to improving the claims adjudication process
“Is this claim valid? How much is our financial responsibility?” These are the two big questions payers want to answer when adjudicating healthcare claims.
Healthcare claim denial statistics: State of Claims Report 2024
The 2024 State of Claims report breaks down the survey findings, including insights into how automated claims technology is being used (or not!) to optimize the claims process and bring in more revenue.
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