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HIPAY

PAYMENT POSTING WITH INTELLIGENCE

VIEW DAILY PAYMENTS FROM INSURANCE ERA, EOB, PATIENT PAYMENTS AND MORE

HIPAAS IS MANAGING REMITTANCE POSTING FOR THE LARGEST MANAGED CARE ORGANIZATION WITH

 12M+ MEMBERS

HIPAAS ADVANTAGE

CONSOLIDATE ALL YOUR SPREADSHEETS INTO ONE AUTOMATED PAYMENT DASHBOARD SYSTEM.

  • Increase average % of claims paid after 1st submission.
  • Increase average % of current claims (0-60 Days)
  • Reduce denial rate.
  • Improve net revenue to the practice.
  • Higher percentage of clean claims.
  • Reduced outstanding accounts receivables.
  • Faster claims payment.
  • Less lost claims.
  • Rules driven setup

PAYMENT ACCURACY AND TIMELINESS

CLAIMS SUBMISSION 

  • Integrate to EHR/Practice Management Software and submit via 837 I, P, D EDI

  • Convert claims data to EDI

  • Validate and correct the claims before submission

  • Smart Claims creation and corrections, save time on data entry and corrections

  • Manual corrections of claims data

  • Data entry screens for CMS 1500s and UB-04s

  • Submit claims electronically via direct data entry (DDE) screens.

  • Queue Line item denials and resubmit

  • Create work queues for line items splits, code changes, payment data changes.

  • Match bank payments

  • Create Patient responsibility bills and accept online payments.

MANUAL EOB PAYMENT POSTING

  • Get Payment information from scanned images of Explanation of Benefit (EOB) documents

  • Post each line item to the respective patient accounts.

  • Resolve missing EOB,  adjustments, write-offs, and balance transfers.

  • OCR Reading

  • Data Entry screen

  • AI driven rules to match Claims

  • Resolve missing EOB,  adjustments, write-offs, and balance transfers.

POSTING PATIENT RESPONSIBILITY PAYMENT

  • POS cash collections, checks, and credit cards (patient portals).

  • Post from collection Agencies

  • Resolve any credit balances

  • Write-offs and adjustments

  • Integrate to Payment Gateway to collect patient portion.

  • Integration to generate notification and reports to send to collection agencies

  • Write-offs and adjustments rules

Resolve Work Queues

  • Report and reroute denied claims

  • Rework and re-submission to payers in a timely manner.

  • Check the secondary payer information

  • Transferring the balance to the patient account

  • Routing the denied claims to appropriate work queues.

  • Making adjustments/ write-offs as per defined policies

ELECTRONIC REMITTANCE ADVISORY (ERA) POSTING

  • Reconcile Claims Payments, 835 ERA and Treasury files.

  • Manual corrections

  • Create missing ERA entries and bank entries

  • Al Driven EFT. ERA and Claims Invoice Match.

  • Reconciliation to claims data.

  • Queue Line item denials and resubmit

  • Create work queues for line items splits, code changes, payment data changes.

  • Match bank payments

  • Create Patient responsibility bills and accept online payments.

DENIAL POSTING & RESEARCH

  • Research Clearinghouse rejections, Payer rejections

  • Research denial reasons

  • Review Eligibility

  • Review Prior Authorization

  • View Financial agreements and demographics

  • Research denial reason codes

  • Extra front-end screening for eligibility denials

  • Research Policy and coverage changes

  • Fee schedule updates

  • Report and reroute denied claims

  • Rework and re-submission to payers in a timely manner.

  • Check the secondary payer information

  • Transferring the balance to the patient account

  • Routing the denied claims to appropriate work queues.

  • Making adjustments/ write-offs as per defined policies

TRACKING AND RESUBMISSION

  • Check the latest status of claims

  • Realtime Claims status check

  • Track claims to payment

  • Daily and on demand reports for claims status

  • Secondary Insurance submission

  • Resubmission for errors

  • Real time A/R view

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GET STARTED

Invest your time where it's needed. Set it up once and auto-scale

HIPAAS supports AWS Cloud, Azure or GCP or On-Prem for Enterprise customers. 

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