CLAIM STATUS
As creators and early adopters in Robotic Process Automation development, API design and development, and systems integration technology, Invicta’s technology engineers approach their work in the revenue cycle management field with a mandate from leadership to “innovate and automate.”
Change for the sake of change isn’t a best practice. Change to evolve, improve effectiveness, efficiency, and the speed at which we deliver services? These are absolutely best practices. That’s why we moved very quickly to build, test, and deploy a real-time claim status solution for our clients. We designed our proprietary solution to be HIPAA-compliant with easy to understand reporting metrics and competitive pricing models.
Healthcare executives want better, faster integrated human/machine solutions
Too many insurance carrier web portals are difficult for hospital claims specialists to use for patient-by-patient status verifications. When claim status verifications can be done quickly with a reduced error frequency and minimal implementation timelines, everything moves faster for the hospital and for patients. We can take these tedious, time consuming tasks off your plate to help expand coverage hours, resulting in increased time and attention dedicated to each patient.
A manual claim status or eligibility check for a patient simply takes much more time than electronic verification. Real-time verification accelerates the process, improving revenue cycle management results for your facilities. Whether you want to use real-time API or “Next Day” batch connectivity, Invicta can customize your solution and identify and secure all available coverage options for your uninsured/self-pay patients. We have flexible file exchange workflows, so we complete the work overnight with viable responses back to clients the following morning.
Patients will benefit
We can assist more patients in identifying all potential sources of payment for their health services, while maintaining a high standard of quality. This creates a positive experience for patients while also improving client cash collected and account receivables that would otherwise be written off as bad debt.
Expansive Payer Inclusion – over 850+ nationwide
Invicta developed our real-time claim status solution relying on automation experts along with veteran medical billing experts. Invicta can produce Real-time Claim Status access to over 850+ payers nationwide including Medicaid, Medicare, Veterans Administration, HMOs, and all major commercial and managed care payers. And, with Claim Status for Medicare part A and Medicare part B, we will add your client NPI/Tax IDs to our Medicare access.
Seamless reporting
One of the most common complaints we hear from prospective clients is how the data elements are reported back. Invicta doesn’t require clients to purchase separate batches for eligibility versus claim status. Whether you are looking to verify a patient’s coverage, or looking for a claim status for your Rev Cycle team, both are available with a single subscription. Second, when we provide a response, we share it in a way that allows the recipient to easily see data elements (via API JSON or .csv) at the claim level as well as the line-item level. Finally, we deliver reporting via an SFTP custom-built just for you.
- Real-time API or batch connectivity
- “Next Day” turn around response time for batches
- Flexible file exchange workflows for batch connectivity
- Complete the work overnight with viable responses to you the following morning
- File exchange delivery via custom-built SFTP just for you
- No tedious payer credentialing requirements – a simple one-page signed authorization form is all we need
- Add a custom field to your return file to facilitate automation or workflows for your internal workflow management system
- Crosswalk your EPIC billing indicators with X12 Claim Status codes to maximize your staff’s efficiency
Easy implementation
Online portal access is not required for our clients to benefit from our proprietary Claim Status and Eligibility solutions. A simple one-page signed authorization form is all that is needed from the client.
Contracted partners with Invicta Health Solutions are immediately connected to our suite of payers for claim status and eligibility and do not need to provide any payer portal credentials or user access information of any kind.
Let’s pose the original question again: What new automation tools should you incorporate into your RCM system right now? We hope you consider the options that integrate: human creativity and innovation with machine-based capacity and higher yield; benefit patients as well as providers; cast a wide net; make reporting more accessible; and are simple to implement.
If you’d like to bring real-time claim status to your organization, contact us at info@invictahs.com for more information.
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When hospital patients don’t have sufficient insurance coverage, they often can’t pay for medically necessary healthcare services.
Financial hardship for individual patients and their families has a direct impact on their healthcare providers. If patients can’t pay for services, providers are not compensated.
Insurance Discovery is a revenue cycle management solution that helps to identify incomplete, inaccurate and/or missing patient information to find the maximum coverage opportunity for hospitals and health systems.
Taking advantage of the newest innovations in Insurance Discovery can make a significant difference for providers’ bottom lines.
Invicta Health Solution’s organizational structure and “automate first” approach led to the launch of a robust, highly effective Insurance Discovery solution. Helping to prevent financial hardship for patients and increasing reimbursements for providers is a win for everyone.
What are the key facts on Invicta’s Insurance Discovery solution?
Our Artificial Intelligence-driven Insurance Discovery solution accesses over 1000 payers nationwide.
- Invicta delivers results along with a patient demographic information data warehouse to address any claims that were denied due to policy terminations.
- We make Medicare, Medicaid and Medicaid HMO coverage details accessible for all 50 states.
- We don’t need a hospital’s existing payer list to produce results. Our solution will customize to ensure that a provider’s payers are already in our robust accessible list. Further, we have customization options to limit certain payers using the technology within our platform.
- No payers are excluded, and all are available with Invicta’s solution.
We use Artificial Technology to build out the “whole picture” for each patient.
- We streamline and optimize critical components of the pre bill process.
- Our algorithms utilize the hospital location and the patient’s demographics, current address as well as any previous address the patient has held over the prior six months when determining payers to check for coverage.
- Our Medicare Beneficiary Identifier (MBI) technology integrates with our Discovery solution to resolve Medicare eligibility gaps and return MBI information as opposed to traditional 271 responses.
Our Insurance Discovery solutions team has decades of experience integrating machine technology with patient-centric customer service standards.
- We serve as an extension of the provider’s business office in all RCM processes, augmenting the team to elevate patient engagement and experience.
- We can assist more patients in identifying all potential sources of payment for their health services, while maintaining a high standard of quality. This allows enrollment team specialists to spend more focusing on self-pay patient engagement.
We identify coverage from payers that other vendors may miss, helping reduce instances of bad debt and improving cash collection.
- We use our experience and knowledge to create faster, smarter, and more accurate results and to implement continuous enhancements to our technology solutions.
- Invicta runs all accounts against our superior technology to ensure there are no other payers available for patients that were perhaps not captured by admissions, reducing coordination of benefits issues.
If you’d like to bring Invicta’s Denial Management services to your organization, contact us at info@invictahs.com for more information.
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