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Average Ratings 0 Ratings

Total
ease
features
design
support

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Write a Review

Description

EMCsoft's Claims Management Ecosystem guarantees that healthcare providers and billing companies submit accurate claims to insurance payers for effective claim processing. This system combines our adaptable claims processing software, Claim Agent, with a comprehensive methodology known as the Four Step Methodology, seamlessly integrating into your claim adjudication workflow. By implementing this strategy, we enhance, facilitate, and automate your processes to optimize claim reimbursements. For an insightful overview of Claim Agent's features and its integration into your claims process, you can request our complimentary online demonstration. Claim Agent efficiently manages the scrubbing and processing of claims, ensuring a smooth transition from provider systems to insurance payers in a timely and cost-effective manner. The software is designed to be compatible with any existing system, ensuring a swift and straightforward implementation. Furthermore, we offer tailored edits, bridge routines, payer lists, and workflow configurations that cater specifically to each user's requirements, enhancing the overall claims management experience. This personalized approach enables healthcare providers to focus more on patient care while we take care of the complexities of claims processing.

Description

Ensure a steady stream of revenue by utilizing a robust platform that accelerates reimbursements through eligibility verification, tracking claims status, conducting audits and appeals, and managing remittances for both government and commercial claims, all integrated into one cohesive system. Take advantage of a sophisticated rules engine that promptly cleanses claims in accordance with the latest CMS and commercial payer regulations, enabling you to rectify any inaccuracies prior to submission. During the claim upload process, confirm eligibility across all payers and identify any flagged issues, allowing for necessary edits before the claims are sent. Reduce the days in accounts receivable by implementing automated workflows for handling audit responses, submitting appeals, and tracking administrative dispute resolutions. Tailor staff workflow assignments based on the specific claim type and required actions. Additionally, automate the submission of secondary claims to prevent timely filing write-offs. Ultimately, enhance your claims revenue through automated workflows that facilitate quicker and more successful audits and appeals, ensuring your organization remains financially healthy. Furthermore, this comprehensive system can adapt to your evolving needs, providing long-term benefits as your operations grow.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

Inovalon Provider Cloud No 

Integrations

Inovalon Provider Cloud Yes 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs No 
Webinars No 
Live Training (Online) Yes 
In Person No 

Types of Training

Training Docs Yes 
Webinars Yes 
Live Training (Online) Yes 
In Person Yes 

Vendor Details

Company Name

EMCsoft

Founded

1980

Country

United States

Website

emcsoft.com

Vendor Details

Company Name

Inovalon

Founded

1998

Country

United States

Website

www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-revenue-cycle-management/

Product Features

Long Term Care

Claims Management Yes 
Clinical Care No 
EHR No 
Electronic Health Record No 
For Home Care Providers No 
For Nursing Homes No 
Geriatric Care No 
MDS Review No 
Patient Records No 
Staff Scheduling No 

Medical Billing

Claims Processing No 
Claims Scrubbing Yes 
Code & Charge Entry No 
Compliance Tracking Yes 
Customizable Dashboard Yes 
Dunning Management Yes 
Invoice History Yes 
Patient Eligibility Checks No 
Practice Management No 
Quotes/Estimates Yes 
Remittance Advice No 

Product Features

Insurance Claims Management

CRM No 
Claims tracking No 
Customer portal No 
Document management No 
EDI data exchange integrations No 
Electronic claims No 
Fraud management No 
Reporting No 

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