Medical Claims Clearinghouse with Integrated Eligibility Checks
Personalized Claims, Streamlined Processes: Healthcare Reimbursement Made Easy
About
We are the only Native Woman Owned medical claims clearinghouse. We value you're time, which is why we provide a single point of contact to eliminate long hold times and impersonal call center experiences.
- Sharp Claim Processing
- The claim is scrubbed and sent to the payer.Â
- ERA's returned with multiple human readable reports to fully understand the ERA
- Complies with all HIPPA standards
- Customized Reports, Analytics and dashboards to help your practice with any reporting requirements
- API Access
- Workflows - separate claims out into workflows for easier handling of rejections.
- Rules Engine
- Customized claim edits to make sure your claims are paid properly every single time.
- Sharp Revenue Tools
- Real-Time Eligibility check report integrated into Healthie appointments with over 2000 payers
- Real-time and batch eligibility checks with over 2000 payers on our portal
- Coverage Discovery - find unknown insurance on self-pay patients
Integration Details
We have connected into the Healthie API to find claims that are ready for batching and allow you to upload them directly into our processing system. The claims will go through a series of scrubbing and the clean claims will be sent to the payer. Our system then updates the claims in Healthie so you know they have been received by ClaimRev and sent to the payer or anything in between! With our easy to use portal your staff can quickly see what went wrong with rejected claims and quickly fix and resubmit those claims right on through the system!
We offer eligibility reports where you can look at upcoming appointments and verify if the patient has coverage and if that patient has the correct benefits for your service.
We offer eligibility reports where you can look at upcoming appointments and verify if the patient has coverage and if that patient has the correct benefits for your service.
Data
Rcm Claim
Rcm Claim
Patient Insurance
Patient Insurance
Data
Hcfa1500
Hcfa1500
Patient Insurance Policy
Patient Insurance Policy
Media
Features
Eligibility
You can run a report for upcoming appointments and check that the patient has active coverage and the correct benefits.Â
Integrated Claim Processing
When creating HCFA claims in Healthie, they are pulled into our processing system by a push of a button. Our system then scrubs the claim for errors, sending the clean claim to the payer. During this entire process, we update the claim in Healthie so that you know it's been received and sent to the payer!
ERA Posting
Once an ERA has come back for your claim, ClaimRev's processing system will update your claim in Healthie with how much the payer paid along with updating the status of the claim so you're always kept in the loop!
Customer Service
We have easy to contact customer service. With just a quick phone call or email you're questions are answered quickly and issues promptly fixed. We're always here to help with your claims.
Next Steps
Complete the enrollment form
Fill out the enrollment form, this will help us create the customer service agreement.
Sign Customer Service Agreement
Sign the completed customer service agreement along with the agreed-upon fee schedule
- Once signed, you will be granted access to the portal.
Fill out the activate a partner form
Let both teams you're ready to activate the integration by using this form link.
Testimonials
Resources
FAQ
Yes! we can save the eligibility information back to Healthie. However, there are caveats; every payer and plan can give us the eligibility data differently. This requires us to work with you to figure out what benefits you need saved, what payers return those benefits and how to convert the data into what is needed and wanted.Â
When payer rejections or clearinghouse rejections happen, we mark the claim in Healthie with the appropriate status so that you know that something is wrong. By going to our portal, you can search for the claims and see exactly what is wrong. At this point, you can from our portal using the editor or you can create a new claim in Healthie and resubmit the claim with the fixes.
