OptimizeAR
In the typical healthcare system, nearly 20 percent of all claims are denied, and nearly 20 percent of denied claims are never resubmitted—resulting in millions of dollars in lost revenue for an average sized hospital (Source: HARA Report). Inadequate information technology, changes in billing and coding regulations, and staff who lack appropriate training regarding the details of new requirements all contribute to a high rate of claim denial. Due to the complexity of the denial process, many Patient Financial Services (PFS) departments are unable to accurately report the true losses, often recording them under "contractual adjustments."
Hospitals also face the challenges of managing and consolidating payment information provided on either paper or electronic-based EOBs.
CareMedic’s OptimizeAR family of products consolidates all payment information into the standard electronic 835 format, automates electronic remittance posting and helps you identify and manage denials to optimize revenue collection. With our system, you can quickly uncover and correct the problems that lead to denials so you can avoid them in the future. Our sophisticated workflow technology lets you review and research payer denial trends, correct errors, develop work lists to direct rejected claim resubmission, and implement process improvements—all from within a single application. We also provide a solution that consolidates paper-based EOB data with existing electronic remittance information, which can then be uploaded to our automated payment posting system, streamlining and consolidating reimbursement management and reporting.
Our newest solution, Denial Recovery Services, combines configurable technology with our technology-enabled services to help you identify, track, manage and recover your denied claims. We couple targeted analysis and process improvement with an option for short- or long-term staffing assistance to help you bring denied claims processing up to date and move forward within an improved framework
The OptimizeAR family includes these solutions:
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Denial Management •
Remittance Posting
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Consolidated Payment Management •
Denial Recovery Services For more information about how CareMedic products can help you, please
contact us by completing our information request form.
