Claims Exception Worklist

Exception Worklists for Increased Productivity and Cash Recovery  

ReMedics takes advantage of its workflow automation technology and leverages exception-based worklists to minimize human error and reduce operating costs. Our exception worklists and work queues can be automated to target specific areas of need, such as: appeals; denial management; secondary billing; audit requests; collection-based activities and other business office requirements.

By incorporating workflow automation into your revenue cycle process, we can dramatically increase productivity, reduce days in AR and increase cash recoveries. Below are just a few examples of how ReMedics improves on AR Management and cash flow.  

Worklist Inquiries

Operations staff can quickly review payment details using a variety of Worklist Inquiries. Criteria for payment review search can include information such as Batch Number, Patient Name, Check Number, Payment Amount, Facility Name and Payor Name. Once the transaction has been repaired, the funds become eligible for transfer, with or without an Automated Clearing House (ACH). 

Unidentified Worklsits for Follow-Up, as an example,  displays items that have been bypassed to the Client because they cannot be identified. This allows a Division or Business Unit to claim an account. 

Correspondence Management

By capturing and routing correspondence through rules-based workflows, items can be entered and worked faster, thereby reducing turn-times and increasing productivity, resulting in improved patient satisfaction and reduced callbacks. The key is having a solution capable of capturing correspondence in all forms including scanned mail, faxes, emails, or any other system. Using the latest best-of-breed tools, tasks such as: auto-indexing; auto-classification; and correspondence routing, we can automatically direct documents to the appropriate personnel.

Third Party Follow-Up

Provide a complete record of all outstanding payment and denial history. Accounts are tracked throughout the payment lifecycle, providing insight into where bottlenecks are occurring in claim generation and adjudication. Aged accounts are routed to user work queues for timely follow-up. By taking a proactive approach to AR management, processing delays are decreased, cash flows are increased, and overall cost to collect is reduced.

Self-Pay Follow-Up & Customer Service

Improve first-call resolution, patient satisfaction and time to collect patient payments by having immediate access to both clinical and financial data from both hospital and physician systems. With patient liabilities continuing to rise, it’s important to find ways to collect copays/deductibles earlier in the process. Worklists can automatically qualify accounts for proactive follow up. For customer service representatives, Account Inquiry within AR Management provides a powerful tracking tool for activities and patient communications.

A/R Collections Management

We maximize collections by capturing information from disparate systems and identifying bottlenecks at the various stages of reimbursement. Automation is achieved through seamless integration of account comments and other financial transactions within the Practice Management System, further promoting information sharing throughout your organization. Definable qualification criteria, customized sorting and filtering make it easy for users to timely resolve account deficiencies. By being proactive in account follow-up and having tools which present financial and clinical data in a user-friendly solution, your organizations Cost to Collect and Days in A/R KPIs can be significantly improved.

Denial Management

ReMedics quickly isolates medical claim denials/defects and prevent future re-occurrences. This increases cash flow and decreases process delays. Denied claims are automatically captured and routed to the appropriate individuals, facilitating timely and effective follow-up with 3rd party payers. By identifying the source of each denied claim, Denial Management allows staff to resolve the root cause of denials, thereby reducing the initial denial rate of future claims and providing a true process improvement solution. See our Denial Prevention and Management page to learn more.