Five things to look for in claims management and EHR integration

Integrating the right claims management application with your EHR software not only optimizes your organization’s efficiency, it also accelerates reimbursements and reduces denials.

But how do you know which claims management application will deliver the benefits you’re looking for? Here are five things to look for in claims management and EHR integration.

One-click, single sign-on

For complete, seamless integration, your claims management and EHR system should allow for a one-click, single sign-on that delivers access to both systems. With bi-directional integration, your team will save time by being able to access two systems simultaneously.

Direct connectivity to Medicare

Your integrated claims management solution should directly plug into Medicare. Cross-checking claims against the latest rules and requirements from the Centers for Medicare & Medicaid Services (CMS) leads to higher rates of first-pass acceptance. Direct connectivity to Medicare also enables claims to be automatically pre-screened and flagged for potential problems to help reduce claims denials.

Automatic secondary claims submission

A claims management system that automatically submits secondary claims using the same information as primary claims submissions further increases efficiency and leads to faster payments. It also can reduce timely filing write-offs that drain revenue.

Customizable business rules

Each organization has its own needs when it comes to claims submissions. A one-size-fits-all solution is unlikely to keep up with payer rule changes, which can result in increased denials. Look for a claims management application that allows your team to input facility-specific rules. A customizable rules engine improves the accuracy of claims filed by each facility location.

Dedicated customer service

To get the most of your claims management and EHR integration, look for a partner that provides dedicated customer service. Personalized customer service can help you navigate the tools that will benefit your organization most and provide assistance with troubleshooting when problems arise.

EHR integration with the right all-payer claims management systems will help your organization improve claims accuracy to optimize revenue. By looking for these five things, your organization can reduce denials and receive payments faster while saving staff time.

Discover how the expanding partnership between Inovalon and PointClickCare can deliver the right claims management integration for your EHR system. Inovalon EASE All-Payer, now part of the PCC Marketplace, has been proven to deliver a 99% first pass claims acceptance rate¹ for healthcare providers.

Sources:

¹ Inovalon internal reporting, EASE All-Payer, July 2022