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Automated A/R Processing

Automated A/R Processing

EqualizeRCM uses its proprietary software to Automate the Accounts Receivable (A/R) process. The tools analyze balances in both Insurance and Patient A/R. The tools start by ensuring claims are billed to the correct payers and eliminating both patient and registration error. Then the system automatically statuses claims as they move through the adjudication process and automatically re-bills claims where feasible. As a result, efficiencies are gained by:

• Knowing which claims to work next
• Rebilling claims without human touch (or delay)
• Routing denials to specifically trained resources
• Working faster with fewer resources.

Knowing which claims to work: our software automatically obtains claims statuses and then routes the claims based on that status and client priorities. Where possible, claims will be automatically re-billed with corrections. The remainder are assigned via our Optimus A/R management tool for the agents to work based on priority. The result is A/R that is resolved faster than ever.

Rebilling the claims automatically with correct insurances: our insurance discovery tool works with both insurance and patient A/R to discover potential payers and to fix incorrectly gathered data (a very common issue for many practices and hospitals). Then the software corrects the information, updates the insurances, and bills the claim out – all automatically in many cases. The result is less patient bad debt and higher collections.

Routing to expertise: knowing specific claims statuses and denials reasons allows us to assign them to specific team members, who have the training and expertise for those denials and payors. The result is claims are worked to resolution more quickly resulting in faster, greater collections.

Work faster with fewer resources: smart deployment of our Automated A/R processing reduces your dependency on people and shortens the adjudication cycle. The software prepares the majority of work for our agents, speeds the process, and ensures our experts focus on the most critical claims.