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Payor837™
Claims Processing and Editing for Health Plans, TPAs and Government Payers
Veredi understands the complex issues surrounding payer adjudication. Minimizing wasteful time and money adjudicating claims with errors is critical to the efficiency and bottom line of your organization. Payor837 is a robust, scalable, high speed yet easy-to-implement rules engine designed to meet the ever changing requirements of your environment and the healthcare industry.
Payor837 Features:
All industry code sets and procedures – CPT/HCPCS/ICD9, diagnoses, CCI, LMRP, revenue
codes, DRG, occurrence codes, value codes, treatment codes, etc. – are fully supported and automatically updated as revisions are announcedEdits can be customized on any field to meet specific needs without software programming or expensive professional services
Supports 837P (professional), 837I (institutional) and 837D (dental) claimsImplemented on a local server or via ASP allowing fast integration
Rules engine runs at blazing speed without sacrificing accuracy
Payor837 Advantages:
Rapidly and precisely identify and eliminate incorrect and incomplete claims before they enter adjudication processingSignificantly increase first-pass adjudication rates and reduce re-submissionsDecrease suspense processingDecrease false accept processing and lossesProvide immediate and explicit feedback to improve provider behavior and relationsFocus knowledge workers on critical business activities |
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