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Rule Based Billing Engine

We know flexibility is critical for your business, that’s why AccuMed features the broadest range of online transaction sets offered in a HIPAA-compliant, secure environment. Detailed reports are available to ensure claims were successfully submitted, accepted, and adjudicated by the paying entity. Insurance eligibility can be verified in real time or in batch form prior to the start of any business day on a service-specific basis. It’s all about enhanced adaptability and productivity for your office.

Detailed Explanations of Benefits are also received electronically from the payer, read by the AccuMed system, which automatically posts all payments to the corresponding invoice and creates a crossover claim to the secondary or tertiary payer, as needed. Additionally, patients can be referred to an appropriate specialist with a single click of a mouse, ensuring the highest possible quality of care, as only the most contemporary and comprehensive technology can offer.

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FEATURES

  • User definable rules
  • Appointment billable/non-billable driven by rules
  • Modify service based on consumer’s age
  • Automatically adjust carved out services
  • Manage rollup services

BENEFITS

  • Facilitates managed care Medicaid billing
  • Prevent claim submission for duplicate services
  • Streamlines Medicaid Nights and Weekend Program
  • Increase accuracy in billing
  • Meet government and commercial billing regulations