Billing Integrity for Healthcare Systems
CMS has shown their clear intent to enforce payment integrity in Provider billing / claims. EHR's are not experts in this area and their systems have proven ineffective at protecting providers. Poor billing integrity can cost you millions. Even worse, it increases overhead through the staffing of employees who do nothing but reconcile billing, resolve payment issues and support audits. With our Billing Integrity Platform, you can analyze proposed bills to get visibility into problems and actionable insight before the problems leave the business office.
Context’s real-time, cloud based Billing Integrity Platform provides comprehensive tools including:
- Pricing leveraging UCR and all 16 Medicare Prospective Payment Systems to facilitate pricing and integrity checks
- UCR for Medicare gap pricing
- Advanced Medicare, Commercial and Medicaid analytics logic to assess payment compliance at a granular level
- Audit logic to define which bills / claims might trigger an audit or require additional documentation to manage audit risk and speed reimbursement