ClaimShark’s Post

MA Plan Leaders: how confident are you in your MSP accuracy? Missed premiums stack up every month due to bad data, but ClaimShark offers a rapid fix to this growing problem. Reconcile and Maximize CMS premiums today with the power of accurate data + automation! #coordinationofbenefits #medicareadvantage #paymentintegrity #claims #automation #artificialintelligence #claimshark

Curious how ClaimShark can make an impact for your payment integrity team? Check out our brand new 90-second overview video for the grand tour! #paymentintegrity #claimshark #ai #cob #audit

𝐓𝐚𝐜𝐤𝐥𝐢𝐧𝐠 𝐁𝐚𝐝 𝐃𝐞𝐛𝐭 𝐢𝐧 𝐇𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞: 𝐊𝐞𝐲 𝐒𝐭𝐫𝐚𝐭𝐞𝐠𝐢𝐞𝐬 𝐟𝐨𝐫 𝐒𝐮𝐜𝐜𝐞𝐬𝐬 Managing bad debt is a critical challenge for healthcare providers. At Providerqure, we believe proactive measures can transform financial health and ensure sustainable growth. Here are some effective strategies: 𝐀𝐜𝐜𝐮𝐫𝐚𝐭𝐞 𝐄𝐥𝐢𝐠𝐢𝐛𝐢𝐥𝐢𝐭𝐲 𝐕𝐞𝐫𝐢𝐟𝐢𝐜𝐚𝐭𝐢𝐨𝐧: Prevent unexpected denials by confirming patient insurance details beforehand. 𝐒𝐭𝐫𝐞𝐚𝐦𝐥𝐢𝐧𝐞𝐝 𝐁𝐢𝐥𝐥𝐢𝐧𝐠: Minimize errors and accelerate payments with an efficient billing system. 𝐂𝐥𝐞𝐚𝐫 𝐂𝐨𝐦𝐦𝐮𝐧𝐢𝐜𝐚𝐭𝐢𝐨𝐧: Help patients understand their financial responsibilities to ensure timely payments. 𝐓𝐢𝐦𝐞𝐥𝐲 𝐂𝐥𝐚𝐢𝐦 𝐅𝐨𝐥𝐥𝐨𝐰-𝐔𝐩: Ensure claims are processed promptly to avoid debt accumulation. Advanced RCM Solutions: Optimize your revenue cycle with Providerqure’s comprehensive solutions. 🔍 𝐋𝐞𝐭’𝐬 𝐂𝐨𝐧𝐧𝐞𝐜𝐭: Interested in transforming your practice’s financial health? Connect with us today to learn how we can help you minimize bad debt and maximize efficiency! #BadDebt #RevenueCycleManagement #MedicalBilling #HealthcareSolutions #Providerqure #Healthcare #RevenueCycleManagement #RCM #MedicalBilling #BadDebt #FinancialHealth

In less than a year of using Claim Pattern Review, one health plan has prevented over $1 million in inappropriate payments, improving payment integrity and protecting members’ benefits. Cotiviti’s vice president of FWA, Erin Rutzler, AHFI, CFE, CPC, CHC, attributes the plan’s success to the diligence of its investigators, along with: • Ease of implementation • Automated prepay review • High acceptance rate and moderately low appeals rate • Focus on high-volume providers Read the case study today. https://hubs.ly/Q02gg3h10 #HealthPlans #payments #FWA

Are you looking to improve your billing and revenue cycle in the healthcare industryessentialere are five essential tips to help you streamline your processes and boost your financial health: 1. Streamline billing procedures 2. Verify insurance information 3. Train staff on billing practices 4. Monitor accounts receivable 5. Implement a denial management strategy For more insights on optimizing your revenue cycle, visit our website at www.provihealth.com. Let's work together to enhance your financial operations and drive success in healthcare! #RevenueCycle #BillingOptimization #medicalbilling

What if we could track every piece of expensive equipment in our healthcare system? How much money could be saved? How would patient care improve? Would it reduce the stress levels of our healthcare workers? Could it change the culture of exploiting services and better protect our tax investment? We believe it can. By knowing the location of all equipment, theft and loss are minimised, saving billions annually. Benefits: ⚕️With reduced theft, insurance premiums can be significantly lower. ⚕️The availability of equipment ensures critical equipment is always available when needed, leading to quicker diagnosis and treatment. ⚕️Streamlined operations mean less time wasted searching for equipment and more time focused on patient care. ⚕️Knowing where equipment is reduces the time and stress associated with finding or replacing lost items. ⚕️Tracking equipment promotes accountability and reduces exploitation of services. ⚕️Resource optimisation ensures that tax money is used effectively and efficiently, providing better value for money. Where would you want this extra money spent once it's protected? Comment below. #HealthcareInnovation #AssetTracking #NHS #PatientCare #HealthcareEfficiency #ScutumGroupUK #ElpasTechnology

Physician receive less, patient pay more, and payors collect billions: the @nytimes investigates how the @MultiPlan_Inc Data iSight tool makes an end run around contracted rates (yes, private equity is involved): https://loom.ly/4n7zffM

Two cornerstones of success for payments in healthcare are the automation of financial processes and the acceleration of digital payments. In our Industry Report, we detail how these two pillars contribute to the overall goal of payment efficacy. #HealthcareAdministration #MedicalBilling #HealthcareIndustry

HealthEdge Source™ paves the way for claims accuracy and reduces overpayments. Streamline your workflow, better detect fraud, and foster better provider relationships—all while saving time and resources. The best part? Your health plan can maintain full control and complete transparency over your payment integrity operations. Learn more about our integrated secondary editing solution, now available to HealthRules® Payer customers: https://ow.ly/jsXJ50RHAWR #PaymentIntegrity #PaymentAccountability #SecondaryEditing #ClaimsAccuracy

The main pillars for establishing an effective Revenue Cycle Management (RCM) system include: Patient Access and Registration: Accurate patient information collection, insurance verification, and streamlined scheduling processes ensure clean claims from the start. Claims Management and Processing: Efficient coding, timely submissions, and effective denial management reduce financial loss and improve cash flow. Financial and Data Analytics: Data-driven insights allow for performance monitoring, process adjustments, and strategic decision-making, optimizing revenue cycles over time. These elements align with privatization goals by improving transparency and financial sustainability in healthcare.  #RCM #HealthcareTransformation #HealthcareFinance