Claims Processing

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By Microsoft 09:16 am June 14, 2017
In the past, custom eligibility, referrals and reporting systems might have overwhelmed the average case worker in an office environment. But as this infographic suggests, modern technology enables agencies to enhance delivery via technology.
By Healthcare IT News 10:48 am March 11, 2014
For health insurers, data integrity and visibility are key to successful integration with the Federal Marketplace. However, complex processes and trivial errors can lead to data gaps that impact revenue, profitability and member satisfaction. Adopting a standarized approach to data integrity early in the process is critical to succesfully adapting...
By Healthcare IT News 03:42 pm July 08, 2013
Seeking to improve daily workflow and decrease A/R days, Roanoke, Virginia-based Carilion Clinic discovered that through tight integration with its Epic HIS, SSI’s ClickON® Technology solutions could help the health system achieve its goals. With SSI, Carilion Clinic now boasts an impressive 47-52 A/R day range for hospital billing and 25-30 days...
By Healthcare IT News 03:40 pm July 08, 2013
At the precipice of the 5010 conversion, Hendersonville, North Carolina-based Pardee Hospital embarked on a change of billing vendors. With guidance from SSI’s acclaimed customer support, the nationally recognized, not-for-profit community hospital thrived during the transition and continues to benefit from ClaimSmart Suite®, SSI’s fourth...
By Healthcare IT News 01:54 pm April 02, 2013
The multimillion-dollar question is: Are you covering who you think you’re covering? This white paper gives insights into the scope of eligibility fraud among commercial managed care organizations, state employee health plans, and state and federal agencies. It also addresses why it is important to incorporate multiple, diverse data sources into...
By Healthcare IT News 12:31 pm February 27, 2013
Atlantic Health System is leading the way in connecting healthcare providers with one another and with patients to help improve care coordination and patient engagement. Increasing levels of clinical connectivity in parallel with improved financial connectivity are driving better care and better financial outcomes. Read Atlantic Health’s story to...
By Resource Central 12:17 pm September 04, 2012
Specialty medicine practices rarely employ a dedicated information technology resource. Durham Nephrology is no exception. The Durham practice navigated the uncharted waters of attesting to Meaningful Use under the HITECH Act of 2009 without the benefit of an IT expert or outside consultant. They implemented an EHR system in 2003 and believed that...
By Resource Central 01:15 pm August 02, 2012
Every HIM initiative - especially clinical documentation - relies on a single common thread for success: the availability and integrity of the right data to drive the correct decisions and follow-on actions. Capturing accurate, complete quality clinical documentation is the most critical and fundamental component in providing quality care, and...
By Resource Central 09:34 am March 01, 2012
This paper examines why health care reform is causing a shift to a consumer-driven business model and the role analytics plays in helping organizations make the transformation successfully. Read this white paper to gain insight on how health insurance plans can come out ahead with advanced customer intelligence and engagement strategies.
By Resource Central 10:53 am December 12, 2011
Curtailing the massive drain caused by waste, abuse and fraud in healthcare has never been more impor¬tant. New payment models are on the horizon, including bundled payments, and greater emphasis is being placed on payment for outcomes. Given the magnitude and visibility of the problem, insurers need to avail themselves of advanced and effective...

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