Improve Claim Acceptance Rates
Improving first-pass claim acceptance rates requires complying with changing payer rules and regulations. Slight delays can negatively impact cash flow, so payer-specific edits are updated four times a week and before the stated effective dates 99%+ of the time. The edit package includes:
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- 837 (institutional and professional)
- Medicare CCI
- Managed Care
- Eligibility Claim Edits (optional module checks eligibility before claim submission)
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Increase Visibility and Automation
Automation and predictive intelligence drive efficiency through just-in-time workflow, enabling staff to focus only on claims needing attention. Leveraging Change Healthcare’s advanced data analytics and payer connectivity.MatrixCare Claims Management provides increased visibility into where claims are in the life cycle and guidance for proactive claim follow-up. Other workflow automation within the solution can facilitate claim error identification, automated secondary claim generation, work assignments, payment clarity, remittance processing, and more.
Integrated Denial Management
MatrixCare Claims Management integrates the data and workflow necessary for efficient denial management, reducing the need for more modules to manage the process. Remittances from all sources, as well as thorough remit-to-claim matching, provide data on denial propensity for work and analysis. Enhanced payer status rules and claim assignment management optimize efficiency by ensuring staff works claims within their skill set and workloads remain balanced. Through analytics modules, extensive denial data analysis is available and can guide strategic decision-making and corrective action to help prevent future denials.
