Rules and Pricing
The Billing Information System contains extensive validations, rules and pricing algorithms to ensure bills are submitted correctly the first time; reducing rebills, improving cash flow and the efficiency of the billing operation. It validates all incoming transaction data, faxes notifications to clients when data is missing, and performs rules that include NCD/LMRP, CCI and payer specific edits. It automatically assigns CPT codes based upon financial class and diagnosis.
Only failures require intervention, which are efficiently corrected through online work queues. Users can be assigned for management and tracking of transactions in process.
Once transactions pass rules processing, they are priced. The application allows the laboratory to create and manage client-specific pricing structures as well as unlimited fee schedules and expected reimbursement definitions.
Features and Benefits include:
- Comprehensive validations and rules ensure clean, compliant transactions that reduce rebills and improve DSO
- Improve productivity by automatically faxing providers to request missing information
- Improve productivity with automatic on-line PDF view of requisitions and ABNs generated via Quick-Req®
- Flexible client discounting and special procedure pricing to be competitive
- Target clients for education with client ranking based on transaction error rate and error type
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