Healthcare Transactions Medical Claims Electronic Processing Software
Our Claim Processing Services provide immediate responses so you can detect claim errors, reduce the risk of compliance issues and ensure accurate reimbursement before claims are submitted to Payers. Real-time processing and pre-adjudication for all claims. Accept real-time and batch inputs. Receive real-time responses integrated into your workflow prior to submission. Our Claim Processing Service supports both provider claims (professional claims) and hospital claims (institutional claims).
Clinical Coding Verification Service – Best of breed clinical claims scrubbing in real-time. Receive responses in standard X12 response format or human readable reports. Configurable filters invoke on per claim basis, based on procedure codes, total charges, provider and payer.
Level I – Includes real-time HIPAA validation, payer edits, delivery to payer, acknowledgement and payer status.
Level II – Includes Level I plus Clinical Coding Verification Services (CCVS) which provides clinical scrubbing including National Coverage Determinations (NCDs); Correct Coding Initiative (CCI) and Medical Necessity edits.
Integration & Reporting – Many formats and integration methods are available for claims and responses; all levels include robust web-based reporting and query capabilities.
- Increase collections and receive full, accurate payment
- Capture missing procedure codes and additional revenue
- Accelerate cash flow
- Cut costs by reducing rejections which reduces your staff’s time to rework claims
- Verify eligibility prior to claim submission
- Ensure payment accuracy, timing and reconciliation
- Detect claim errors, rejections and potential denial issues prior to submission
- Reduce compliance risk by reducing your exposure
- Easy to use and understand responses
- Define your own views, workflows and reporting
- Define your own business rules as part of your workflow
- No system changes – We can work with your existing systems and vendors or carry your transactions
Automate request and response for claim follow up. Flexible inputs and outputs for easy integration with your systems. Validate and track claims through their entire life cycle. Receive everything that the payers store and HIPAA supports including HIPAA claim status codes, rejection reasons and paid date. Also supports manual input or launch a transactions from and existing record.
- Reduce phone calls
- Improve billing accuracy
- Cut costs
Automatically post EDI 835 responses in a variety of formats, use powerful query functionality to access or human readable formats for easy storage, retrieval and workflow integration
- Eliminate paper checks and EOBs
- Reduce phone calls for reconciliation issues
- No system changes
Streamline Your Billing Process with Patient Friendly Statements
Patient Statement Processing
With customized, easy-to-read statements, DataLink’s Patient Billing solution promotes clear patient communication, leveraging the HFMA Patient Friendly Billing Standards. Our statements display your personalized Patient Portal URL, allowing your patients to view statements and make payments online to accelerate your payments and reduce costs and time to collect. In addition, DataLink supports address standardization and correction services as well as mail return management for easy, cost-effective billing.
The One Bill solution enables providers to deliver a simple, consolidated online or mailed statement for services across an entire organization to give patients an easy and convenient way to manage and pay their healthcare bills. Reduce print and mail costs by consolidating multiple statements and make it easy for patients to receive eStatements. Collect, post and reconcile patient payments efficiently with funds deposited into your bank accounts and payments posted into your existing source A/R systems. Plus, increase visibility into your payment data with access to robust reporting 24/7 – all without any disruption to your workflow.