Revenue Cycle Management
Manage and improve your revenue cycle
MD Clarity’s claim calculation engine is integrated with a data feed from our customers’ databases. This allows us to simulate claim adjudications on thousands of accounts nightly, providing a steady flow of payment estimation data and reports that find incorrectly processed claims.
One in five claims are reimbursed incorrectly by insurers. Traditionally, claims are spot-checked manually to provide insight on payer performance. MD Clarity automatically audits every claim, identifies trouble areas, and organizes this data into reports showing precisely where contractual errors are being made. Using this insight, staff can focus on true appealable opportunities.
Procedure Category Metrics
This suite of reports provides granular detail on how payers are performing. Healthcare organizations can pinpoint types of services where an insurer is systematically making a claim adjudication error. They can look at trends based on time, problems with individual procedure codes, and specific claims from billing data where there are inconsistencies. This gives organizations actionable data at their fingertips to make sound financial decisions.
Contract Performance Metrics
MD Clarity provides healthcare organizations with a range of configurable reports enabling them to identify issues with contracted payers. These reports quickly identify which payers are not meeting their contractual agreements. They also show which contracts have a higher overall yield and how insurance payments stack up against patient responsibility.