Blue Bean Software and LCS have had a long term relationship that spans 7+ years. LCS provides medical billing and claims processing services to number of healthcare providers in South Africa. Through the previous years we’ve helped architect and improve the accuracy of claims submission as well as streamline administrative procedures that resulted in faster claim adjudication and payment. The ample benefits of electronic transactions include simplified paperless management, automatic processing to eliminate redundancy and quick dissemination of information.
Solution
We’ve developed a solution to catch and fix claim errors in minutes rather than days or weeks. The result is fewer denied claims and significantly higher claim success, as well as fast claims processing, ability to file claims in batches and reduction in human error.
Using the realtime claims processing solution has helped improve provider relationships major insurance carriers like Discovery, Momentum, BestMed, Bonitas and hence mitigating long wait-times for claim enquiries and shorter payment cycles that lead to more accurate revenue forecasts.
Some of the core functions of the solution includes
- real time validation for bill completion prior to transmission to payor
- notify provider if data is missing or in error
- transmit supporting documents/medical reports to payor with bill, and
- pass payor acknowledgement of bill back to providers.
- eligibility verification to determine patient portion before appointment
- electronic remittance advice (ERA) to automatically update payments and adjustments
- claim status reports
- rejection analysis to help translate error codes
- online access for editing and correcting claims online
- real-time support for personnel, one-on-one support and training
- claims that can be printed but also tracked and managed online
