Without accurate information about the patient, their history, the reason for their visit, their primary and secondary insurance coverage status, it is impossible for the elements of Revenue Cycle Management to function properly. With proper data, much more is possible, including better population health analytics.
Failure to properly capture this initial information can result in time-consuming and costly claim denials. himagine streamlines the registration processes, allowing organizations to avoid downstream errors and confusion. The result? Clean claim submissions the first time.
Using their Eligibility & Benefit Verification knowledge, our team can easily collect, validate, and document the necessary insurance information, from insurance and patients, before a claim is submitted to ensure a smooth process and an appropriately paid claim. Our teams are trained in the use of more than eighty different hospital billing, PM, EMR/EHR systems and client proprietary systems.
- Eligibility Verification – himagine team members validate and update patient information, including all personal and contact identification, detailed information about their insurance coverage, requirements, limitations and insurance contact info, any special accommodation needs, as well as the patient’s Social Security number. Up to 75% of claim denials are the result of problems with patients either being ruled ineligible or not covered for certain services
- Referral and Authorization Check – In every healthcare organization, it is vital that accurate referral and authorizations are in place prior to care being rendered. This task is fundamental in making sure that claims can be properly created, submitted, and paid. Your himagine team is made up of experts in this area. They will ask the right questions and make sure all necessary authorizations and approvals are in place.
- Medicaid Screening – For many practices, Medicaid is an important source of revenue. But, without deep expertise, Medicaid regulations, requirements and limitations can be confusing. This is where himagine’s experts come in. We’ll help you get it right the first time and make sure your Medicaid claims are off to a good start.
- New Patient Account Creation – The greatest risk of high-impact errors occurs at the beginning – when a new patient account is first added to the system. Let himagine onboard new patients, so your team can focus on providing frontline and revenue generating care to patients. We’ll make certain the data in these accounts is 100% complete and accurate