CLAIMS MANAGEMENT

GHN-Online’s claims and data management enterprise-class platform streamlines the healthcare revenue cycle, helping the billing staff optimize the speed of claims to cash. Through zero-defect manufacturing methodologies and targeted business rules, our solution helps eliminate non-compliant claims upfront prior to submission to the payers. GHN’s revenue cycle management solutions provide real-time visibility and control throughout the life of the claim for payment predictability.

Features:

Enterprise design provides flexibility visibility and control.
Extensive rules and edits with real-time Smart Scrubbing™, backed by LMRP and CCI validation, maximizes first-pass, clean claim rate to payers.
Our Business Process Improvement (BPI) approach to a fully-vetted electronic transaction services synchronizes billing data to eliminate lost transactions and shortens the revenue cycle process.
Claims status matrix gives real-time visibility through the entire life cycle of each claim – submission, receipt, file and claim acceptance, payment.
Efficient tools to resolve and resubmit any rejected claims. Consultative service executive provides continuity to eliminate any rejection patterns with auto-correction edits.
Flexible, open platform seamlessly interfaces with third-party systems (payers, providers, banks).

Benefits:

Clean, complete claims virtually eliminates the need for medical claims resubmission.
No more lost transactions, duplicate batches and redundancies in your claims management operations.
Optimized turnaround time in cash payment receipts (combined with electronic funds transfer).
Improves cash predictability, claims-on-hand and payment cycle days.
Streamlines claims correction and resubmission through direct data entry.
Reduces operating costs and improves scalability with lower per claim filing costs.