Find Accurate Patient Insurance Verification with DecisionPLUS
Do you spend more time fixing pending claims than processing clean ones?
Are you constantly fixing pending claims? If more resources are spent fixing claims than processing clean ones, you may need to reconsider how your patient data is verified. Simply your workflow and reduce errors by utilizing an automated solution. Let smart technology do the work for you so you don’t have to.
What are the most common reasons for rejections?
Did you know? 36% of rejections are generated from missing or invalid data and payers don’t move rejections to adjudication meaning that until those errors are fixed, the claim simply does not exist to that payer. Interestingly enough, 50% of rejected claims don’t get worked and end up written off as bad debt. Other reasons behind claim rejections involve the following:
Eligibility
Payer ID missing or invalid
Billing provider National Provider Identifier (NPI) missing or invalid
Diagnosis Code
Deadlines for timely filing
We understand that not all data provided for claim filing is accurate or up to date. With intelligent verification, you can retrieve updated demographics and accurate patient insurance verification.
Patient demographic updates include information such as a name change, address change, new phone number or simply correct data provided that had keystroke errors causing a missing or transposed digit, such as a social security number (SSN) or date of birth (DOB). Even with the correct member ID, a payer can reject a claim because of a bad name or DOB, secondary to that is other invalid or missing information such as address, city, state and zip. Intelligent verification takes your data further with DecisionPLUS™ to find and correct payer information needed to maximize reimbursements.
What is DecisionPLUS™?
DecisionPLUS™ uses smart technology to go a step beyond the ability to verify patient demographics and insurance eligibility. With DecisionPLUS™, you can find updated and corrected data for payers without a physical card present. Find accurate patient insurance verification with the click of a button.
DecisionPLUS™ Features:
Medicare Benefit Identification (MBI) Tool
Finding Medicare IDs has never been easier! Prevent Medicare rejections by filing the Medicare claim the first time. Avoid rework on Medicare claim submission with tevixMD’s Medicare Benefit Identification (MBI) Tool. Within 30 seconds, you can find missing or corrected member IDs with the click of a button.
Extended
Enhance your searches with verified patient information to find more information regarding patient benefits, Medicare Advantage Plans, HMOs and Secondary Payers. Lightning Payer ID puts the power to finding patient benefits without Member IDs.
Payer Mapping
Prepare claims for a complete submission process by mapping eligible payers to your order entry ID/billing system. Payer mapping helps reduce rejections and denials by submitting claims to the correct payer the first time.
DecisionPLUS™ Benefits:
ID Retrieval vs. ID verification – DecisionPLUS™ will give you the right ID, not just tell you that you have the wrong one.
Primary/Secondary - Identifies and delivers both with Medicare & Medicaid
Improved Patient Experience - Avoids unnecessary bills.
Liability - Avoid state fines by properly identifying Medicaid/Medicare patients for balance billing.
Reduce manual work - Give back time to billing reps to prioritize other tasks
Optimize your workflow and utilize the tools need to maximize reimbursements. Reallocate your staff to process claims instead of working rejections! Find accurate patient insurance verification faster and easier than ever before. Let DecisionPLUS™ do the work for you and prepare cleaner claims.