Claimsure | Sláinte Healthcare Software Solutions

By: Slainte Technologies  09-12-2011
Keywords: Health Insurance, Revenue Cycle

Claimsure is a comprehensive health insurance revenue cycle management solution, supporting all aspects of the claim cycle. Easily accessed within facilities over a browser, Claimsure is straightforward to implement, is easy to use, and delivers project paybacks in months, not years.

What are the benefits to healthcare service providers?

  • It reduces the amount of time needed to be spent on Private Health Insurance claims…across your entire practice and support staff enabling you to realise substantial reductions in (a) time from discharge to submission of claim, (b) time from submission of claim to payment, (c) rate of pended claims and (d) rate of rejected claims.
  • It improves the quality of communication with the insurance companies…no longer discussing lost or delayed claims as they are electronically submitted on a daily basis.
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  • It links with new developments such as pre-validation of insurance cover and pre-authorisation of treatment plus it’s secure and fully backed up, nothing is ever lost.
  • It works the way you do, taking best practice from the industry claim process and configurable for service provider process requirements. For valuable internal staff, the time saved can be more productively used in other aspects of their roles to add value across the hospital.
  • It can be implemented quickly, in phases, enabling a migration of work in progress whilst new claims are processed electronically.
  • It enables you to manage by exception, allowing fast follow-up of unpaid submitted claims (pended, rejected, part-paid or no response).
  • It releases sustainable financial benefits through a significant reduction in debtor days and aged debt, and the generation of additional cash for working capital purposes.
  • It places the service provider in an ideal position to drive revenue maximisation and cash collection as part of both a devolved and shared service finance model.

What are the benefits to clinicians?

  • It can be accessed anywhere…Consultants can access at home or in the office and see an electronic worklist of their claims remotely, securely, review and sign electronically.
  • It’s quicker to use…Clinicians can review multiple electronic claims at a time, and sign them all off using just one signature, in one easy step.
  • It can invoice directly or link to what you’re already using…Consultants can choose to invoice directly from Claimsure, or it can connect directly to their own Practice Management System to link the invoice to the claim with no paper.
  • It increases the cashflow of consultants’ income tied up in third party claims.

A sample of features are listed below:

  • Demographics and signature capture at admission point;
  • Insurance cover validation in real-time;
  • Aggregation of clinical summary for provider/physician billing;
  • Consultant/Physician signature support for claim approval;
  • Reconciliation of physician code charges to provider codes;
  • Invoice generation from source data as desired;
  • Pre-submission validation of claim to reduce denials, returns;
  • Code libraries tailored to end-users;
  • Progressive elimination of paper from the entire revenue cycle process;
  • Automated reconciliation of payments/denials/returns and;
  • Leverages existing technology infrastructure with tight integration.

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Keywords: Health Insurance, Revenue Cycle

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