Relieves the burden of a complicated registration and collections process, enabling organizations to reduce registration errors, maximize collections, and squash the main sources of revenue leakage.
Helping providers tackle their most critical issues, and streamline workflow, on the front-end of the revenue cycle. This scalable platform provides a powerful synergy of integrated information from multiple verification sources, along with intelligent guidance for staff to help reduce costly errors.
Patient liability, or self-pay, is now the third largest payer behind Medicare and Medicaid.
-National Association of Healthcare Access Management
Address & ID Validation
Inaccurate demographic information causes claims to be rejected and can also lead to potential HIPAA violations. With SSI Address & ID Validation, organizations can determine patient address deliverability, confirm identity, and obtain current contact information to seamlessly update the hospital information system. By ensuring accurate information, claims and invoices process more quickly, decreasing A/R days and denials.
SSI Address & ID Validation reduces input errors by validating and correcting a patient’s name, address, telephone number and other demographic information in real time, at any point in the revenue cycle. Accessing multiple demographic data sources, patient information is returned to the registrar, highlighting differences and allowing them to take appropriate action, as defined by the organization’s business rules. The solution eliminates the need to move outside of the registration system, which allows registrars to continue to process patients during the validation process.
With SSI Address & ID Validation, your organization can:
- Prevent input errors
- Reduce returned mail and time spent resending correspondence
- Minimize patient identity-related denials
- Eliminate the need to manually update patient data
- Maintain address standardization within the information system’s master patient record
Without real-time verification while the patient is present, organizations cannot determine and collect co-pays and deductibles at the point-of-service. SSI Eligibility enables providers to verify patient insurance coverage and benefits to allow for successful pre-service payment collection. Immediate, automatic, and real-time, SSI Eligibility maximizes collections and allows registrars to devote more time to other registration duties.
In a perfect world, registration staff would obtain accurate information and verify eligibility for every patient. But how do you ensure you are achieving this objective? The Eligibility module initiates a real-time 270 eligibility inquiry during the registration process, as soon as the necessary data elements are entered, and returns an easy-to-understand 271 customized response.
With SSI Eligibility, your organization can:
- Reduce claim rejections through identification and remediation of insurance issues
- Simplify and maximize point-of-service collections by easily – and immediately – collecting patient co-pays and deductibles
- Identify Medicaid or Medicare coverage for self-pay patients
- Automatically identify and collect on retroactive insurance coverage
Medical necessity accuracy is critical to successful registration. With SSI Medical Necessity, providers can determine the correct codes to validate medical necessity and issue Advanced Beneficiary Notices (ABNs) prior to service. Acting as a checks and balances system, the solution enables organizations to reduce the risk of lost revenue and non-compliance.
SSI Medical Necessity provides the front-end solution to quickly and easily check diagnoses against procedures. The tool helps determine whether a Medicare service is medically necessary to help ensure the provider receives payment. If a service is not reimbursable, it provides registrars with an ABN sign-off for the patient, which protects the organization from unexpected liability for charges, allegations of Medicare fraud and potential fines for billing of uncovered services.
With SSI Medical Necessity, your organization can:
- Decrease medical necessity denials and unnecessary write-offs
- Reduce the need for Advanced Beneficiary Notices
- Improve compliance
- Enhance patient satisfaction by clarifying patients’ rights and obligations prior to service
Authorization & Pre-Certification
Manually submitting pre-certifications and authorizations can produce delays and increase an organization’s error potential. The SSI Authorization & Pre-Certification application initiates a real-time authorization/pre-certification (278) request at the earliest point in the registration process, returning a customized response that allows users to see, and act on, the 278 data most pertinent to their organization. With SSI Authorization & Pre-Certification, providers can reduce claim rejections and improve their cash flow.
With SSI Authorization & Pre-Certification, your organization can:
- Reduce claim rejections
- Minimize registrar errors related to diagnosis codes
- Eliminate manual processes and streamline workflow to recoup time and resources
- Maintain compliance with Medicare regulations
Patients who are uneducated about their financial responsibilities are less likely to pay than those who understand their monetary obligations. With SSI Estimation, organizations can determine patients’ estimated out-of-pocket expenses and payment possibilities through a pre-service cost estimation process and effectively communicate these items to the patient.
With an increase in patient financial responsibility, providers must determine a way to adjust the timing of patient collections with accurate data. SSI Estimation applies intelligent logic by calculating procedural charges, analyzing historical data, evaluating contract pricing between your organization and the payer, and applying patient benefit information to establish the patient’s estimated financial obligation at the earliest point of contact. Automated intelligent guidance converts the complex estimation of the patient’s obligation to a customized script that the user simply reads to the patient.
With SSI Estimation, your organization can…
- Prepare patients to pay with pre-service estimates
- Significantly increase point-of-service collections
- Reduce days in A/R for patient out-of-pocket responsibility
- Increase price transparency
- Minimize patients’ anxiety about financial obligations
- Identify and arrange payment options prior to service, based on estimated cost and ability to pay
With bad debt and collection costs on the rise, it is imperative for healthcare providers to be proactive in identifying a patient’s ability to pay and acting on it at the point of service. SSI Payment Assessment improves collection efforts by determining the patient’s ability-to-pay, checking existing credit history, and alerting registrars of the appropriate action to take – from point-of-service payments to financial counseling.
SSI Payment Assessment predicts both the likelihood and ability of a patient to pay their portion of medical charges. Armed with accurate patient financial information, providers can then customize individual payment programs to align with the patient’s payment capability’s and their organization’s payment policies.
With SSI Payment Assessment, your organization can…
- Create, deploy and manage payment policies consistently across your entire revenue cycle
- Access key predictive scores for patients, in addition to household income and financial burdens
- Establish appropriate payment plans
- Strengthen collections efforts
- Eliminate open accounts
After calculating a pricing estimate for a service and communicating payment options to the patient, it is essential to collect while the patient is in front of the registrar. SSI Payment Processing simplifies the payment process by accepting various payment types – cash, check, credit card, discount programs, etc. The solution provides straightforward and consistent patient invoices, along with reports to help track collection rates and timing.
SSI Payment Processing provides simple and consistent patient invoices, along with reporting capabilities, which help providers track collection rates and timing to identify goals, benchmarks and opportunities.
With SSI Payment Processing, your organization can…
- Set up recurring payment plans
- Provide simple and consistent patient invoices
- Identify and collect on outstanding patient balances