Simplify Claims Management Process with PrognoCIS
"Our software has many tools to monitor revenue utilizing our RCM reporting dashboard"
What is the Purpose of Claims Management?
There’s no doubt that time and money are precious for busy medical professionals and their staff. It is therefore important for practices to streamline and automate their workflows. Simplifying Claims Management Process with PrognoCIS offers numerous advantages like efficient revenue cycle management (RCM), reduced denials and higher profit margins.
How RCM helps in optimizing revenue generation.
Prognocis integrates with multiple clearinghouses: Trizetto, Waystar (Zirmed), Daisy Bill, Jopari
Tools for Scrubbing claims:
- Scrubber checks, pop up warnings or errors, LCD scrubber checks, CCI edits, Global day alerts
- Auto-posting, EOB automatically interfaces from clearinghouse and auto-populates figures.
- Account Receivable follow-up every 30 days with reporting transparency
- Detailed Denial Transaction Report
Our software has many tools to monitor revenue utilizing our RCM reporting dashboard which is customizable. Sample dashboard report:
Understanding Our Claims Management Process
To understand how our claims management software functions, here is an overview of the claim management process.
At the start, our implementation team will make sure your current data is imported into our EHR software. The team will then assist you with the entire revenue cycle onboarding process.
Specific functions completed from a single encounter include:
- Professional + ASC Claims Employer + TPA + Work Comp + Self Pay claims
- Split Billing for DME
- Split billing for Professional + Institutional Claims
- Automated Split claims workflow for Employer Billing
Bulk Claim functions: An Added Benefit
Highlights of this Bulk Claim function include:
- Ability to create up to 100 claims at once for different patients with the same services
- Useful for employer billing, bills generated for routine services like physicals or lab checks – One-click transmission for numerous claims
Claim Submission Process in Medical Billing
Claims management and medical billing often go hand-in-hand. Fortunately, our software can manage both functions in a single platform.
Medical billing is one of the most time-draining processes for a practice and their staff. Fortunately, PrognoCIS offers practices with an “in house” billing experience by assigning account managers.
Our dedicated managers both stateside and offshore will provide the following services:
- One-on-one weekly calls and meetings
- Weekly and monthly financial reports
- Denial analysis
- Claims holds reports
- Open chart reports
- Outstanding AR reports
- Patient Financial Counselors
Medical Revenue Cycle Management
While claims and billing are certainly beneficial features that our software offers other helpful features such as:
- Fast and easy appointment scheduling
- Insurance eligibility and confirmation including batch eligibly
- Electronic claims submission via connections with multiple clearinghouses
- Automated patient statements
- Electronic payment posting
- Follow up and reporting services for every claim that is over 30 days
How Our Claims Management Software Will Benefit Practices
Ultimately, the benefits equate to billing efficiency, time, and revenue management. The seamless integration allows medical professionals to spend more time taking care of their patients rather than toiling with administrative tasks. Handling medical claims and billing is a monumental task, and it’s best to automate and streamline those processes. To learn more about PrognoCIS Billing and RCM services, read our blogs
