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Monday, September 06, 2010

 

 

Claims Management

Do you want to lower your outstanding accounts receivable?
Do you know where your claims are in the reimbursement process?
Are you capturing all of your revenue?

ZirMed’s suite of web-based solutions assist providers in administering the business side of healthcare. From eligibility verification to submitting claims, we help providers evaluate their patient’s ability to pay. Our remittance tools save hours of wasted re-keying and provide necessary internal controls. Our fulfillment solutions utilize state-of-the-art technology allowing providers to view patient statements on-line. Electronic statement delivery and web-payment result in quicker turn-around of cash flow.

 

Why ZirMed?  Because we solve problems. Healthcare is a difficult business. Administrative inefficiencies and costs steal valuable resources from providers and limit dollars that may be invested in patient care. Our revenue cycle management solutions are designed to alleviate inefficiencies and reduce costs.

  • Providers experience greater control over processes, increased cash flow, higher staff productivity and more dollars per patient visit.
  • Payers choose to partner with ZirMed because we work to increase the percentage of claims submitted electronically. Our flexible and innovative technology is capable of converting any format to a HIPAA compliant 837 transaction. Through extensive edits and adherence to detail, we strive to have 100% pass-thru rates.
  • Practice management vendors and partners select ZirMed because we make them look better. When you select a partner, it is important to know that the partner appreciates and understands the trust involved. It's not just our innovative and creative technology solutions, but also our dedication to customer service.

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Claims Management- ZirMed's Claims Management System, provides users power over the electronic claim filing process. Data can be accepted in ANY format including National Standard Format (NSF), HCFA-1500 Print File, ANSI X12 837 (HIPAA), and any other proprietary data format.

The Claims Tracking feature allows you to follow the progress of the claim every step of the way. ZirMed will forward claims to the payer immediately in real-time, where available, and otherwise in a prompt manner. Payer claim acknowledgements are reflected on the Web site. Rejected claims may be edited on-line and immediately resubmitted.

ZirMed offers extensive tools to assist in the management of claims. Our highly popular Rejection Analysis engine categorizes rejected claims by the rejection reason, allowing the user to address issues affecting the highest number of claims first and resubmit.

 

 

Coding Tools- ZirMed continues to develop innovative ways to supply simpler provider solutions that are fast, affordable and secure. This includes ZirMed's on-line procedure and diagnosis code management tools. There's no more thumbing through those huge books or looking for the CD to cross match valid codes. With our coding tools you can search by code, part of a code or even by description or keyword. The tool is integrated with the Claims Management System; When entering or editing claims, you can use the Code Management Screen to maintain frequently-used codes, as well as directly enter codes into a claim. Codes are available for current and prior years.

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Features

Real-Time System
All ZirMed applications operate in real-time. Upon receipt, claims are immediately validated for integrity and forwarded to the payer. Results of real-time processing are instantly available on the ZirMed site. In many cases, claims submitted are processed by ZirMed, delivered to the payer and accepted or rejected (with rejection reason) by the payer within seconds. ZirMed provides easy to understand rejection analysis linked to the claim. We take extra steps to help providers immediately resolve issues and resubmit claims utilizing our On-Line Claim Correction Module. Other ZirMed solutions such as Eligibility Verification, Electronic Remittance Advice (ERAs) and Fulfillment Services (patient statements) operate real-time.

Timely Filing Issues are virtually non-existent
ZirMed’s unique claims tracking system means that providers know where claims are in the process at all times. Our tracking system allows providers to see the step-by-step process of a claim from submission, through two levels of ZirMed edits, to payer acceptance or rejection. No more wondering where your claims are.

Increased efficiencies
The number of man-hours needed to track and work rejected claims is substantially reduced. This is due to ZirMed’s unique way of standardizing reports from all sources including ZirMed, payers, and any intermediary that may be utilized. With the reports all being listed on one screen, there is no need of searching through stacks of reports searching for claim rejections. Once a rejected claim has been identified, you are able to work and resubmit that claim online through a familiar HCFA-looking edit screen.

Tools to Manage Your Business
Our analytical tools assist managers and business owners in evaluating the effectiveness of their business office functions. Rejection analysis reports demonstrate trends and common areas for improvement. As healthcare reimbursement continues to be cut and contracting more difficult, our tools allow providers to dissect payer mixes and evaluate common procedure codes. National providers and billing services use our detail reports for individual business units as well as aggregated data at the corporate level to test variances. Need a report or have an analytic question – just call your account representative and inquire.

ASP / Internet Based Solution
Tired of installations, upgrades and software maintenance? With our ASP / internet based solution there is no software to install and the service is always current. As long as you have internet access and Internet Explorer 6.0 or greater, you can manage claims from any desktop – even from home.

Practice Management System / Billing System Integration
Our solutions work with all major practice management systems, and even proprietary billing systems. ZirMed’s flexibility and innovative technology means that we will accept the challenge to integrate even when others can’t.

Eligibility Verification
Tired of watching your administrative team call to verify eligibility? Through either a direct entry or batch process, ZirMed provides a one-stop solution for verification. We can pull your schedule or your entire customer base and verify benefits real-time while you sleep. Our direct data real-time model alleviates uncertainty for new patients and walk-ins. Either way, you can feel confident about your patient’s health benefits and your ability to get paid prior to rendering service.

Fulfillment
The patient pay portion of healthcare is rapidly increasing. With Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs) and Flexible Spending Accounts (FSAs), healthcare providers are faced with the challenge of collecting more of their dollars from the patients. Our Fulfillment solutions recognize those challenges and are tailored to assist your administrative staff. No more printing invoices and stuffing envelopes. Give us your file, review the statements on-line prior to printing and we send our professionally printed color statements, collection letters and customized mailings. Our technology cleanses addresses and our Fastforward® service integrates with the United States Post Office change of address database to deliver statements to patients that may have moved. We are working diligently to offer e-statement delivery Summer 2005, contact us if you are interested in this state-of-the-art feature.

Pass-Through Rates
Our goal is 100% first-time pass rate. We work closely with payers to apply standard HIPAA edits and custom payer required/requested edits to achieve our goal.

 
 
 
 

 

 
 

 

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