Healthcare Systems Integration

Connecting Core Business Systems for Accurate and Efficient Revenue Cycle Processes 

Many key players are involved in ensuring a smooth flow of claims from the provider to the payor as well as funds from the payor back to each practice. Strategic partnerships, along with the automated workflow technology, enable us to deliver fully integrated patient financial management solutions and BPO services that help to lower operational costs, increase staff productivity and optimize your return on investment.

Our Systems Integration Benefits:

    • Clients can maintain existing practice management (PM)  and line of business (LOB) Systems
    • Receive ERA files for all payors/providers, including those that only provide paper
    • Normalize 835 & 837 data across payors and providers
    • Ability to support system specific data requirements
    • Provide other solution offerings to augment functionality: such as denial management, payment rate verification, A/R worklists, appeals and grievances, etc.
    • Integration history with over 40 claims and EMR/PM systems
    • Easily migrate data and convert to new line of business systems 

Financial Institutions

Selecting a capable partner is crucial to ensuring that the capture process starts smoothly.  Banks partner with us to offer healthcare customers the capability to streamline and accelerate the payment posting processes.

ReMedics Model Advantage:

    • Utilize a single corporate bank account to track all incoming deposits
    • Utilize a corporate lockbox for centralized EOB, claim & correspondence capture
    • Practices can maintain existing banking relationships and accounts
    • Experience with dozens of banks at both national and regional levels

Clearinghouses

Clearinghouses can now offer, along with their other services, automated processes for posting all types of payments, including: Insurance payments, patient payments, legal reimbursements, clinical trial payments, and others.

ReMedics Model Advantage:

    • Clearinghouse agnostic solution to leverage existing relationships
    • Support a multiple submitter, single receiver approach for complex provider environments
    • Utilize a single corporate receiver for incoming electronic remittance advice (ERA)
    • Practices can maintain existing clearinghouse relationships for submission
    • Workflow solutions for both eligibility (270 / 271) and claims status inquiry (276 / 277) and response transactions

Payors

ReMedics is able to reduce some of the barriers that typically exist when dealing with the payor community, including inconsistent ERA/EOB delivery, co-mingled remittances and funds re-association challenges, as well as other payor workflow management solutions.

ReMedics Model Advantage:

    • Properly handle the breakdown of remits for each division on a claim-by-claim basis
    • Additional data validation by ReMedics to provide ‘missing’ data from payors
    • Ability to allocate Provider Level Adjustments to individual divisions
    • Convert paper to 835 conversion services
    • Provide re-association services regardless of inbound formats (ACH, Check, ERA, EOB)
    • Experience with national and regional payors, including Workers Compensation
    • Appeal and grievances management solutions
    • Credentialing workflow solutions