Is your claims adjudication process a source of escalating costs and rising inefficiencies?
Without the right front-end claims scrubber software tool, you could be misallocating thousands of dollars.
FirstPass™ by Context4 Healthcare provides genuine front-end claims scrubbing functionality, meaning that claim errors are flagged prior to the claim entering your adjudication process. With this type of pre-adjudication editing for technical and clinical errors – The end result will be a more efficient claims process that reduces expenses and enhances cash flow management
Reduce Claim Processing Costs and Increase Workflow Efficiency
A reduction in claims handling costs by avoiding the processing of fatally flawed claims is just one example of how Context4 Healthcare’s claims editing tool works to reduce the expenses associated with payment for claims failing to meet reimbursement requirements.
By examining the entire claim, FirstPass™ identifies provider oversights, detects procedure to diagnosis mismatches, and reduces overall risk associated with paying flawed claims. With the ability to increase efficiencies, payers can enhance their overall cash flow management.
The following is a sampling of 1656 edits, and the resulting cash flow management possibilities due to overpayment of flawed claims that is offered by FirstPass™:
| Category – Description | Count | Amount |
| Technical Edits | 319 | $754,839.00 |
| Reporting Edits | 543 | $681,554.00 |
| Documentation Edits | 26 | $78,000.00 |
| Unbundling/Bundling Edits | 71 | $185,215.00 |
| Regulatory Edits | 9 | $21.00 |
| Global Period Violation Edits | 13 | $39,000.00 |
| Utilization Edits | 64 | $174,405.00 |
| Provider Oversight Edits | 26 | $78,000.00 |
| CPT/ICD Linkage Edits | 30 | $44,950.00 |
| Other Edits | 544 | $727,229.00 |
| Total | 1,656 | $2,763,543.00 |
From this sampling of 1,656 edits, a total of $2,763,543.00 in overall payments for inaccurate claims was identified.
Integration with Existing Claims Process
FirstPass™ can be integrated into an existing claims process. Customers can take advantage of Context’s online solution, FTTP, API or use Context’s proprietary software development kit to communicate with our editing application.
Learn more about the advanced claims editing and auditing benefits of FirstPass™ at http://www.context4healthcare.com/
