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RCM/Financial Info Systems Solutions Guide

Eliminate paper-based payments VeraFund Manager uses advanced payment and remittance processing support from BNY Mellon to deliver an end-to-end automated patient/payer solution for healthcare providers. This next-gen solution not only digitizes and processes paper- based payments from patients and payers, but also creates electronic remittance transactions from paper-based remittance advices, automatically indexes all correspondence, matches payments to original claims and prepares a posting fi le for easy import into an administrative system. Automatic reconciliation of payments, claims and bank deposits offers immediate return on investment. ZirMed

Salary-based premium calculations included The HEALTHsuite administrative system now supports the variation of health insurance premiums based on employee income. This functionality provides tangible benefi ts to organizations looking to avoid the fi nancial penalties associated with the Patient Protection and Affordable Care Act. The enterprise solution automates all aspects of health plan administration, including functionality for eligibility and enrollment, benefi t administration, provider contracting and reimbursement, medical/ utilization management, premium billing, care management, claims processing, customer service and contact management, reporting, EDI and more. RAM Technologies

Score a perfect ICD-10 The 10Smart Solution is an a-la-carte grouping of three product sets designed to facilitate a perfect ICD-10 transition. ClickON ClearView ICD-10 enables providers to validate newly coded claims from their host system against ICD-10 edits to ensure compliance. ClaimSmart Suite allows providers to bill ICD-10 coded claims electronically to all payers and easily track payments. A/Rchitect, a four-part, cloud-based set of products, spans the ICD-10 conversion continuum from pre- paredness fi rst steps (such as historical utilization analysis) to post-conversion monitoring tools that aid in ongoing contract negotiation. SSI Group

Upgraded audit tracking and reporting software AudiTrends Online, an updated version of the formerly titled Audit Tracker Online, expands the functionalities of tradi- tional recovery audit contractor (RAC) software to allow healthcare providers to manage incoming medical record requests for all types of payer audits. These include private payers, quality improvement organiza- tions and other Medicare- and Medicaid-based audits from initial medical records requests through stages of appeals and payment resolutions. This customizable software manages patient information, workfl ow, correspondence, audit determinations, various stages of appeals processes, deadlines and documents in one central and secure location. MRO

RCM with add-on cloud modules Artiva Healthcare Advance is the newest addition to the Artiva line of hospital revenue cycle management software that improves the collection functionality of accounting systems, increases account representative productivity, maximizes management control and reduces administrative costs. This solution includes enhanced HIPAA and PCI compliance, new data service partners, hosted or on-premise options and access to cloud-based add-on modules and services, such as disaster recovery, speech analytics, cell-phone validation and authorization, e-consent and more. Ontario Systems

Improve front-end revenue cycle processes The Access Integrity suite is designed to help healthcare providers improve cash collections, reduce front-end denials and improve effi ciencies during patient registration. This fl exible solution unifi es disparate systems to remove complexity for patient access staff. Intelligent process automation and workfl ows presented through Web-based tools drive staff ac- tions and deliver easy access to critical data required to fi nancially clear patients prior to service. The result is a fl exible, affordable solution to signifi cantly improve an increasingly critical area of the hospital that impacts bad debt and patient satisfaction. MedAssets

28 May 2012


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