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When a healthcare benefits provider (the Payor) accepts claims electronically and, assuming your billing software is capable, you would send these claims to your software vendor or claims processor wherein fees are charged which typically apply to a percentage of the total amount billed. Industry standard fees can range from 1% up to 8% and usually indicative of the volume of claims submitted. |
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ACI processes millions of claims with immediate turn around. ACI’s E-billing fees are fixed and NOT a percentage of the amount due you. ACI’s E-Billing fees can cost as little as .10 a claim. Process your manual claims for $1.00 a claim. The ACI challenge:purchase a postage stamp, an envelope, an employee to print your claims (free of errors), a printer cartridge, and the not less than the thirty (30) day turn around to obtain payment and see if your practice can do it faster or cheaper? ACI, in managing the HIPAA claims transactions process, works with healthcare providers and hospitals hand-in-hand to provide an entire revenue cycle solution. Key transactions addressed through ACI’s Revenue Management Technology include: 837 I / P / D – Institutional/Professional/Dental Claims Beginning early in the patient encounter, ACI’s Practice Management System helps the admission/registration process by enabling a hospital to conduct the front-end functions of:
Admissions can quickly determine if a procedure is deemed medically necessary. This is based on published rules from Medicare/Medicaid Fiscal Intermediaries published Scalable Claims Processing Solutions Because no two hospitals are identical with their business processes, ACI’s Practice Management System is scaleable to accommodate the needs of any sized hospital or large healthcare facility. Available in either an onsite solution with either clearinghouse connectivity or direct-to-payer submission or an application service provider solution (APS) ACI’s claims processing software fits the unique needs of any large healthcare enterprise. Along with ACI’s core technology for claims editing and transmission, there are a range of vertical products that facilitate and enhance claims management. These include: Secondary and tertiary claims represent a large percentage of revenue for many hospitals. Billing these claims can be an efficient process with an integrated claims solution. ACI’s Secondary Billing enables hospitals to produce secondary and tertiary claims, along with a one-page Explanation of Benefits (EOB) attachment by posting 835 files (electronic remittances) to claims already in the billing package. Along with 835 files, the Secondary Billing package can post lock box files, payment files produced from the hospital information system and the Medicare pending payment files that the Accelerated Secondary Billing and ACI’s Claims Status packages produce. Capturing revenue from secondary or tertiary claims is vital to the financial success of a large healthcare enterprise and being able to capture it quickly is extremely important. ACI’s Accelerated Secondary Billing assists with just that. This package is an enhanced version of the ACI’s Secondary Billing package. Enhanced functionality enables the posting of pending Medicare payments to the appropriate claims in ACI’s Billing after the checking the Medicare Common Working File (CWF) for their status. The entire accelerated secondary billing process allows claims to be billed to secondary payers before the primary payment has been received. Tying the steps of the billing cycle together into a seamless, integrated process provides for major advantages. For instance, the billing secondary claims before the primary is billed can result in an eight-to-ten day collection advantage. The ACI Claims Status Module (CSM) is one solution that brings together multiple activities for working claims and providing detailed reporting. This advanced claims management system works directly with the ACI Billing package to status Medicare claims using the Medicare Common Working File (CWF) as well as claims submitted to any other payers that provide the 276 and 277 claims status transactions. With fourteen (14%) percent of all claims denied, the healthcare industry is losing valuable revenue that negatively impacts the bottom line. ACI’s Revenue Recovery Manager is an innovative denial management tool which improves the overall revenue cycle by analyzing denied claims, providing workflow solutions and offering comprehensive reporting. This application can even prevent denied claims. Transaction data is analyzed and, based on predefined criteria specific to a particular facility, tasks to handle denied claims are automatically assigned to individual users or to everyone in a designated group. FREEDOM OF CHOICE If you are already using an in-house software produce, ACI’s Revenue Management Data system can accept claims from virtually any billing software. Alternatively, you have the freedom to choose to use ACI’s On-Line Medical Billing and Appointment Scheduling Practice Management Software. Many healthcare providers have simply grown tired of purchasing new software, upgrades, or completing total overhauls. Your end of day billing task is now substantially reduced from 30-60 minutes to about 10 minutes. Simply log in to your own private Client User I.D. and upload your claim file from your billing software. In less than a minute, you can view the confirmation report. If there are any errors, you can correct the claims immediately, on-line, quickly and painlessly. When finished, click the submit button and your claims will be electronically processed in an instant. INSTANT PAYMENT Access to paid claims is simple and easy. Log in to view paid claims, down load accounting reports, down load payments made…. all in real time and in an instant. Costly Software? Billing and Practice Management - With ACI’s On-Line Medical Billing and Appointment Scheduling Practice Management Software, you will never have to purchase software again. Upgrades are provided by ACI FREE of charge to all our clients. Why purchase a software program costing $25,000, $50,000, $100,000 or more? ACI’s custom data system is working 7 days a week, 365 days a year, and is accessible to all doctors and healthcare provider clients in real time, any time, with a simple internet connection. Data Storage and Retrieval - For our Radiology and Medical Imaging Clients, and clients in need of Data Back-Up Storage, ACI also provides data storage and retrieval. Doctors or Administrators, when in an emergency situation, or are out of the office, or on the move or traveling, always maintain access to their practice management data files, patient data, or image files. Access all data from your PDA, laptop or cell phone. In an emergency situation, doctors are able to Email or forward patient data files and image files to the current attending physician in seconds. As an Administrator, you are attending a Board meeting but forgot your reports or prefer to conduct a live demonstration. No problem.Access your data instantly. Efficiently customize reports, graphs, and provide accounting statistics with detail in an instant.
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