Simplifying Medicare Billing in PointClickCare

Medicare billing in PointClickCare can often extend beyond the platform itself, requiring billing teams to log in to multiple systems to verify eligibility, manage claims, and track reimbursement. Connecting Inovalon’s Claims Management Pro™, available in the PointClickCare Marketplace, with Medicare claims management and eligibility verification solutions help to give staff the information they need to keep claims moving with less manual effort.

Key takeaways:

• Understand where the biggest inefficiencies in Medicare billing typically occur after claim creation.
• Learn how connected revenue cycle solutions help support billing teams throughout the reimbursement process.
• Practical ways to improve billing efficiency, reduce manual effort, and increase visibility across the revenue cycle.
• How one growing skilled nursing facility achieved a 99% clean claim rate while supporting continued expansion.

The challenges of Medicare billing in PointClickCare

PointClickCare is central to the way many skilled nursing facilities (SNFs) operate. It’s where claims are created and the work of keeping the revenue cycle moving begins. But once a claim is ready, many billing teams have to leave PointClickCare to complete the next steps.

Whether it’s verifying eligibility, managing Medicare billing in PointClickCare, checking claim status, or following reimbursement through payment, staff often work across multiple systems to move a claim forward. None of those tasks are unusual, but completing them in different places adds time, creates duplicate work, and makes it harder to keep claims moving efficiently.

As billing volumes grow, those disconnected processes become more difficult to manage. What starts as a few extra steps can quickly become hours of additional administrative work each week.

Your team shouldn’t have to be the integration

Revenue cycle technology should help billing teams move work forward, but disconnected systems often do the opposite. Every time someone leaves PointClickCare to complete billing somewhere else, they become responsible for connecting information that already exists across the revenue cycle.

That responsibility doesn’t just add another step to the process. It depends on staff remembering where to find information, manually tracking claim progress, and carrying work from one system to the next. Over time, those workarounds become part of the daily routine, even though they were never meant to be.

Build on the technology you already use

SNFs have invested in PointClickCare because it is central to their daily operations. Extending that investment with connected revenue cycle capabilities helps billing teams accomplish more without changing the way they work.

That’s where Inovalon’s solutions come in. Available through the PointClickCare Marketplace, Claims Management Pro helps billing teams manage all-payer claims from submission through payment without needing to sign-in in other tools.  When paired with Medicare claims management and eligibility verification solutions, teams can simplify Medicare billing and identify coverage issues before claims are submitted.

What changes day to day?

When the information billing teams need is easily accessible, their day instantly becomes more productive. Less time is spent tracking down information or managing disconnected processes, leaving more time to focus on the claims that need attention.

• Verify coverage earlier
  Identify eligibility issues before claims are submitted, helping reduce avoidable delays and rework.
• Simplify Medicare billing in PointClickCare
  Complete Medicare billing activities without relying on separate Direct Data Entry (DDE) processes or logging into multiple systems.
• Manage all-payer claims with greater visibility
  Track claim activity, prioritize exceptions, and spend less time piecing together information across systems.
• Build on your PointClickCare investment
  Bring these capabilities into the workflows your billing team already knows instead of introducing another disconnected process.

A more connected workflow in practice

By adopting Inovalon’s connected revenue cycle solutions, the Ignite Medical Resorts increased its clean claim rate to 99%, accelerated billing timelines, and supported multi-entity billing through periods of rapid growth and change-of-ownership transitions. Those results gave Ignite the flexibility to support continued expansion while maintaining an efficient billing operation.

By adopting Inovalon’s connected revenue cycle solutions, Ignite also accelerated billing timelines and supported multi-entity billing through periods of rapid growth and change-of-ownership transitions.

Get more from PointClickCare

PointClickCare is already central to the way your billing team works. Extending it with all-payer claims management, and more, helps your staff spend less time managing disconnected processes and more time keeping claims moving toward payment.

Explore the PointClickCare Marketplace integrations.

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