HEALTHCARE CLAIMS CHALLENGES

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Wendy Edwina Dorsey
8 years ago
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1 Discover comprehensive, efficient technology for managing today s HEALTHCARE CLAIMS CHALLENGES

2 TECHNOLOGY THAT CAN MAKE A DIFFERENCE Today s shifting and changing healthcare environment makes managing and processing claims more challenging than ever. Healthcare organizations are increasingly under pressure to process claims efficiently and without error, yet often depend on manual processes and incomplete solutions. Whether the objective is to audit, reprice, model contracts or manage data, healthcare claim processing is a fluid and evolving critical function that demands better solutions. Chart-tech provides comprehensive, efficient healthcare claims technology that can: Help identify overpayments from erroneous claims payments consistently and expansively Increase efficiency and reduce operational costs Save time by streamlining processes and eliminating manual steps Improve customer service levels Help you make better business decisions AGILE AND RESPONSIVE SERVICE Our healthcare claims technology provides tremendous benefits to our customers. But that s not the only advantage you ll get from working with Chart-Tech. You ll also get agile and responsive service that meets your needs. That s because Chart- Tech is a privately-owned enterprise with a tight-knit, passionate and dedicated group of technology and healthcare professionals. We ll work one-on-one with you to custom-tailor a solution that meets your business needs and helps you achieve your organizational goals. DISCOVER THE CHART-TECH DIFFERENCE Chart-Tech provides proprietary innovative technology-based healthcare auditing and claims services that help payers and third-party administrators save time, reduce operating costs, increase productivity and avoid costly claims adjudication errors. Chart-Tech technology has a proven track record of helping customers identify recoverable revenues, effectively model provider contracts and boost profits. We approach claims auditing with the understanding that it is a complex process that requires not only a complex solution, but a complete one. For example, our agile, efficient and innovative software reprices every single claim and evaluates payment integrity across an entire population of claims, not just a cross-sampling, like many other consulting companies. Chart-Tech proprietary technology helps you recoup overpayments and identifies incorrect payments much more thoroughly and completely in less time and with less people. So our software may be complex, but the end result is simple. Chart-Tech helps you identify recoverable money that other companies can t.

Whether the objective is to audit, reprice, model contracts or manage data, healthcare claim processing is a fluid and evolving critical function that demands better solutions.

3 INTELLIGENT SOLUTIONS FOR HEALTHCARE The VISIUM Suite is comprised of four main components that work seamlessly together through the entire process. From contract loading to repricing to revenue recovery operations and contract modeling, VISIUM gives you total control, superior reporting and full interoperability across all modules. The VISIUM suite of products is designed to be completely customized and provided either as an on-site or hosted solution. Enterprise Contract Management System (ECMS) Contracts are a very fluid part of the managed care business. What you need is a user-friendly, flexible tool for effective contract management. ECMS offers a friendly, straightforward user interface for efficient and accurate contract loading. Powerful functions minimize repetitive entry of business rules and make updating of contract renewals painless. Innovative technology handles the toughest, most complex business rules easily. Generate a Contract Summary (as a hard copy or electronic file) for a concise representation of all the business rules of any contract. Contract Compliance Monitoring System (CCMS) Complexity and high volume. That s what healthcare claims professionals face daily. CCMS is the solution and can help your organization dramatically increase productivity, boost accuracy and help recover revenues. CCMS provides efficient tools for measuring, assessing, and reporting claims payment errors. Root cause analysis prevents erroneous payments and future leakage for clean claims processing from the beginning. Process Trail, Contract Summary and other unique analytical tools give you transparency, control and precise claims information. The proprietary business process integrated into CCMS is the most efficient, high-volume auditing method available today. Access the Contract Summary and the actual provider contract from within any claim. Contract Modeler What if? That s the question contract professionals have to ask when analyzing reimbursement under alternative contract scenarios. The problem is that answering this simple question can be an extremely complex undertaking. But not with the VISIUM Contract Modeler. Leverage claims, payment and contract data in an interoperable environment for modeling that covers all the bases. Compute expected reimbursement scenarios fast with an average processing rate of 2,000 claims per minutes. Make multiple and simultaneous changes to any or all business rules for in-depth analysis. Take the guesswork out of modeling and get the reliable tactical intelligence you need for strong negotiations. Repricer The Repricer is the core of the VISIUM Suite and powers all major components. The Chart-Tech Repricer can also stand on it s own as a powerful, agile and flexible utility within your current claim system. Integrate with your current system to perform concurrent audits as a double check on payment accuracy. Generate a Process Trail that describes how each claim was repriced in plain English. Web-enabled, so that claims information can be accessed on a secure website for authorized parties to view. Online claims viewing may lower call center volume and decrease operational costs. DATA STORAGE, CLAIMS MANAGEMENT AND IT CONSULTING SERVICES Chart-Tech offers innovative data warehousing solutions that places your critical enterprise data at the center of your organization for a streamlined, holistic view of all your claims data and history. We also offer a wide spectrum of management services and IT consulting to give you a complete solution to all your technology and claims processing needs.

The VISIUM suite of products is designed to be completely customized and provided either as an on-site or hosted solution.

4 SUPERCHARGE YOUR TEAM VISIUM technology can reprice up to 2,000 claims per minute and pinpoint the industry average of 2-6% of mis-paid claims. Your team won t waste time chasing dead-ends. A single analyst can evaluate hundreds of claims a day and you ll get greater productivity through enhanced efficiency. NO CLAIM UNTURNED Because the claims environment is dynamic, Chart-Tech s technology was designed to be dynamic too. A claim paid accurately today may be adjusted and erroneously paid tomorrow. With VISIUM, you can monitor claims activity indefinitely. There are many healthcare claims challenges today. HERE S ONE INTEGRATED SOLUTION The VISIUM Suite from Chart-Tech Besides the claims auditing process, there are several key areas that need to be firing on all cylinders in order for your healthcare organization to see increased revenues, higher operational efficiency and greater stakeholder value. Chart-Tech s flagship technology solution, the VISIUM Suite, is a web-based, integrated software platform that enables your organization to detect over- and underpayments, boost productivity and improve customer service. Engineered from the ground up to be highly flexible, agile and powerful, VISIUM adapts to your organization s unique business processes and accommodates the most challenging and complex environments for unmatched benefits: Increased claims payment accuracy for lower operating costs and greater provider satisfaction Greater productivity from your claims processing operations using less resources and manpower Powerful, reliable and comprehensive auditing technology for superior revenue detection Root cause audit analysis helps identify pricing deficiencies so they can be corrected at the source for greater operational savings. Extensive contract modeling analysis that gives you strong tactical information for effective term negotiations Repricing capabilities that provide transparency, advanced reporting and high-speed pricing for unparalleled efficiency

NO CLAIM UNTURNED Because the claims environment is dynamic, Chart-Tech s technology was designed to be dynamic too. A claim paid accurately today may be adjusted and erroneously paid tomorrow.

5 Let us show you how our technology can GIVE YOU A COMPETITIVE ADVANTAGE Today s healthcare organization must thrive in a very competitive environment and claims processing is a critical factor that determines success. Chart-Tech technology has a proven track record for helping organizations recover monies, cut costs and boost operational productivity and efficiency. Let us show you how Chart-Tech technology can give your organization a competitive advantage today. Call today for a free consultation. Reimbursement dynamics & predictive analysis with speed and flexibility Contract management & repricing with power and reliability Contract loading and maintenance with high productivity and performance Revenue recovery & contract compliance with efficiency & accuracy CORPORATE OFFICES: Chart-Tech, Inc Sherman Ave. Suite 500 Evanston, IL Telephone: Toll Free: Fax: Visit us online at

Let us show you how Chart-Tech technology can give your organization a competitive advantage today. Call today for a free consultation.

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