The amount of change coming your way seems unprecedented, and you need to be ready. With the advent of the 5010 mandate, the looming testing dates, and health reform set to change how payers and providers interact, now is the time to look at state-of-the-art solutions for electronic claims processing that go beyond simply parsing and translating data.
Many organizations are using EDI software developed between 1998-2002 to handle insurance claims electronically, whether from Providers through Clearing Houses to Payers or from Payers back through Clearing Houses to Providers. New regulatory mandates, such as HIPAA 5010 and ICD-10, present unique opportunities to improve critical business processes – from administration simplification and medical management to network management.
Watch our webcasts to understand the value both Evolute and Microsoft bring to health organizations dealing with the transition to HIPAA 5010.
Providing documents you can read – and easily transmit
Evolute’s SureClaim for Healthcare converts HIPAA 5010 transactions into electronic documents that are human-readable and machine-readable. Health plans can tightly couple administrative transactions with customer service, medical management, and finance processes – including claims auditing, investigations, authorizations, referrals, fraud and abuse, utilization management, appeals/grievances, and enrollment management.
SureClaim for Healthcare processes claims quickly, efficiently, and more accurately via a portal. As repeatedly observed, physicians and organizations using SureClaim for Healthcare have improved their efficiency, productivity, and data accuracy through improved payment turnaround time, reduced rejected claims, and improved patient relations.
Evolute is committed to serving the healthcare industry with technology innovation that positively impacts both patient care and costs of care delivery.
Features & Benefits
- Manage new transactions to enhance partner communications and operational efficiency
- Transaction and Trading Partner Portal
- Manage and report on all transaction activities
- Add human workflows
- Administration and Clerical Cost Reduction
- Reduces manual handling of data, errors, and rework
- Improves productivity and business controls
- Integration with Systems
- Enhances data accuracy
- Reduces costs
- Electronic Claims and Payments
- Transfers information faster and more accurately electronically
- Exchange claims and payment information directly with trading partners
- Foundation Technology
- Enable enterprise wide integration and SOA strategy
- Create a truly agile enterprise
