Claims Monitoring

Automatically Monitor Health Insurance Claims

Providers often struggle with getting visibility into the status of their claims. Staff time and resources can be tied up each day attempting to manually monitor health insurance claims that do not yet have a remit. And because there is little time to spare, only the highest priority claims receive attention leaving revenue on the table due to a lack of follow-up. ZirMed Claims Monitoring automatically provides early insight into the status of your claims as soon as the claim has been accepted into the payer’s adjudication system. It helps reduce manual intervention, time, and resources required to follow-up on claims that do not have a remit, and allows providers to work only the accounts that need attention.

Automate Claim Monitoring and Reduce Your Manual Processes

The Claims Monitoring solution automatically monitors the status of your claims at the payer. Based on your payer data, we calculate the average remit date and send automated claim status inquiries accordingly. You can also set custom schedules to accommodate your specific payer follow-up workflow.

Work Only the Claims that Need Attention

With Claims Monitoring, manual claim monitoring activities are automated to free up staff for more valuable tasks such as working denials. Staff can work by exception and attend to only the claims that need it, allowing for a more comprehensive follow-up beyond just high dollar claims. You’ll reduce the need for outsourcing and will shrink revenue left on the table due to an inability to follow up.

Reduce AR and Get Paid Faster

Claims Monitoring notifies you of pended claims so you can intervene early in the process and get paid faster. You’ll also be able to eliminate mass claim resubmissions and avoid refiling claims that are delayed but not at risk.

Simplified, Easy to Understand Payer Responses Help You Take Action 

ZirMed’s Claims Monitoring software also provides easy-to-understand, plain English ”translations” of claim status messages. These simplified responses make it easier to understand the status of the claim, and along with categories that we assign to each claim, the solution recommends what action should be taken to follow up.

Custom Integration Files Delivered to your System

Claims Monitoring facilitates workflow in your own system, so there’s no need to change processes.  The solution can be integrated with your HIS or you can work directly in ZirMed.

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