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Revenue Management: New
Electronic Claims, Eligibility Verification and ERA Processing
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Claim submission:
Claims
are run against a set of pre-claim edits to check medical
policies, CCI edits, CPT and Dx codes, and user rules before the claims
are submitted to the payor. Warning flags indicate if there are issues
with a claim so that the claim can be corrected before submitting for
payment. Fixing claims on the front end reduces the time it takes to pay
the claim and can help a practice generate additional revenue by
eliminating rejected claims that often aren’t researched and resubmitted
for payment.
Flexible claims processing includes the ability to process
professional/1500 claims and institutional/UB claims with intelligent
processing for accurate transactions.
Comprehensive claim history including claim edits and any reports posted
to the claims is easily available with one-click access.
● Eligibility verification:
Integrated eligibility with complete and accurate eligibility reports
enables a practice to verify a patient’s eligibility for services.
New eligibility data entry and processing logic in Lytec 2010 allows
practices to define when the system checks for updates to payor IDs.
● Electronic remittance advice (ERA) posting:
The ERA functionality in Lytec has been significantly upgraded with
Revenue Management. Previously Lytec required that an entire 835
remittance file be posted all at once. If there were errors, the biller
had to go back into the system, find the errors and fix them one at a
time. It was a tedious process. Now with Lytec 2010, remittance details
are displayed in an intuitive window that allows the biller to review
the payment information before posting, make changes if necessary, and
post (or not post) each individual payment and adjustment.
After posting is complete, a report is generated to show exactly what
was entered into the system. The new ERA posting process greatly
improves the productivity of a practice’s billing staff.
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Features
