If you know the right reason for claims rejection, then you know how to fix it.
For Healthcare providers, revenue cycle management is an integral – but complicated component of ensuring an organization runs efficiently and effectively.
A clear visibility to Revenue Cycle Management is vital for any Healthcare providers
Cephal Claim Analytics Tool give an answer to entire queries to your Revenue Cycle Management
Your claims revenue to each insurance payers & Third party administers
Claims revenue collected from insurance payers & Third party administers
Claims revenue collection turnaround period from insurance payers & Third party administers
Pending claims revenue from insurance payers & Third party administers and its aging
Claims rejection analysis from insurance payers & Third party administers
Leading reason for your Claims revenue
Leading rejection analysis based on treatment activities
Interactive analysis for Claims rejection
Data Clearing House
Cephal Healthcare Data Clearinghouse provide the ability to take in non-standard data and process it into standard data formats that can be ingested into any pertained regulatory bodies, insurance payers, healthcare Analytical tools…etc.
Cephal Data cleansing or data cleaning is to detect and correct corrupted or inaccurate records from patient record set, table, or database and refers to identifying incomplete, incorrect, inaccurate or irrelevant parts of the data and then replacing, modifying, or deleting the dirty or coarse data.
Revenue Cycle Management System
Revenue Cycle management (RCM) is the financial process between healthcare providers and insurance payers, where utilizing the right RCM technical tool and process that facilitates to process the claims activities more efficiently and effectively.
Revenue Cycle Management - Operation
Along with RCM system, equally important to have an experienced medical coders and other supporting RCM operational resources for effective RCM outcome.
Pharmacy Benefit Management
Cephal Pharmacy Benefit Management is an automated Clinical Screening Solution, using technology to support clinicians with making better informed medication-related decisions. It is designed to alert clinicians and pharmacists making prescribing decisions to information about avoidable medication errors, inappropriate dosing and adverse events.
Claims Audit - Patient Record Audit
Group of trained RCM professionals (internal or outsourced) who are involved with the patient from the start of their care to the very end when payment is made. They assign appropriate codes based on a patient's record and bill. These codes are made into Pre-approval & claims that are sent to the patient's insurance company/TPA.
Medical coding and Audit Tool
Medical coding can be incredibly laborious to assign medical codes. The complexity of the medical coding process has increased due to the latest healthcare reforms. There is demand for perfect documentation and its coding. Anything less than perfect, means, rejected claims, or, worse still, fines for miscoding.