SourcePlus Payer Claims Management: Increasing the Speed and Accuracy of the Claims Management Process

SourceMedical’s complete suite of Revenue Cycle Management (RCM) tools enables
healthcare facilities to automate the entire spectrum of patient and payer business
transactions, improving cash flow and productivity while reducing A/R days.

Our Internet-based solutions interface seamlessly with your SourceMedical software,
enabling your facility to better manage and improve the entire claims management and
submission process.  With a robust, real-time claim ‘scrubbing’ engine, online claims
correction functionality and vast national electronic payer connectivity, the SourcePlus
RCM solutions take your surgery center to the next level – significantly increasing ‘first
time’ payer acceptance rates, speeding claims payment and improving staff productivity.

Real-time eligibility verification - With electronic access to eligibility information,
healthcare organizations can dramatically reduce staff time spent on the phone with
payers while improving the overall claims submission process, reducing claim rejections
and improving cash flow.

Web-based all-payer claims management - Our next-generation claims
workstation solution includes a robust, real-time claim ‘scrubbing’ engine, online claims
correction tools and enterprise-wide claims tracking and claims reporting capabilities
that allow healthcare organizations to better manage the entire claims submission
process.

Electronic patient statement processing - Our optional electronic patient
statement solution increases patient collections, improves A/R management and
reduces the high costs and lengthy delays associated with manual, in-house patient
statement printing.

Collector’s Desktop (optional) - With Collector’s Desktop your facility can:

• Automatically assign collectors to work accounts based on multiple criteria
• Design the collector workspace to meet individual collector’s needs
• Perform all collection activities from a centralized workspace to maximize productivity
• Generate letters, patient statements, bills and insurance tracers within the workspace
• Enter collection-related comments when talking with payers or patients
• Access related registration and billing, and assign action dates from within the workspace
• Utilize pre-defined triggers to initiate collection activity and follow-up
• Automate collections correspondence to insurance carriers and patients
• Maintain collection-related activity and correspondence history
• Monitor collector productivity
• Turn over accounts to outside agencies

In addition, the system’s powerful claims management reporting system enables users
to easily track claims across the entire reimbursement cycle, gain vital insight into
claims error trends and monitor cash flow trends across the entire enterprise. 

Features of SourceMedical’s RCM Solutions:

• Robust real-time claims scrubbing engine increases first-time claim acceptance rates to 97% or higher
• Automatic claim error-seeking feature quickly identifies claim errors for immediate correction and resubmission
• Electronic connectivity to more than 1,000 payers, including Medicare, Medicaid, BCBS, commercial payers and HMOs
• Remote ‘print and mail’ claims functionality eliminates staff time spent on manual claims printing and mailing
• Enterprise-wide reporting provides instant access to vital claims and cash flow trends
• Every transaction is processed in compliance with the latest HIPAA standards, including available X12 file formats
• No special hardware or software is required; upgrades, such as changes in payer requirements, are made without disruption to users

SourceMedical’s Clearinghouse-Flexible Support Levels
By focusing on the development of long-term partnerships with proven RCM leaders,
SourceMedical can offer clients the best possible solutions and support service allowing
you to determine the level of functionality and support offered by each clearinghouse.

Affiliated Partners - Our affiliated partner clearinghouses include ZirMed and PayerPath.
SourceMedical clients receive favorable pricing from our affiliate partners, and the
added benefit of integrated support between our support departments to provide the
best possible client support and continued new technical capabilities and functionalities.

ZirMed (www.zirmed.com) and PayerPath (www.payerpath.com) can accept data
in several formats and allow you to follow the progress of the claim to the payer
immediately in real-time, where available. Payer claim acknowledgements are
reflected on the Web site, and rejected claims may be edited on-line and immediately
resubmitted. Both offer the ability to print and deliver paper claims for any payers that
do not accept electronic claims, as well as the printing of patient statements. Their
systems interface easily with the facility’s system and require no hardware or software
to install. Real-time validation and integrated Medicare Fraud & Abuse edits are only
a few of the reasons why many centers have chosen PayerPath or ZirMed for their 
electronic medical claims system.

Supported Partners - Our supported clearinghouse partners include Emdeon (www.
emdeon.com); GHN-Online (www.ghnonline.com); and ViaTrack (www.vitrack.com).
SourceMedical’s clients receive support for UB04 and HCFA-1500, X12i and X12p
claim formats, or print image formats.

Unaffiliated Clearinghouses – SourceMedical extends limited support capabilities to
clearinghouses other than those listed above. Any periodic changes or extraordinary
support required by the clearinghouse may be billable.