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Reimbursement Review |
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Using proprietary software with a rules-based engine that stores payer’s algorithms and utilizing artificial intelligence, re|solution analyzes a provider’s claim submissions and remittance advices. re|solution creates an impact analysis of revenue, charge capture and process improvement opportunities. Using this impact analysis, re|solution reviews individual claims to rebill those that have underpayments, invalid denials and other reimbursement issues. Process improvement changes, training of internal staff and monitoring of results is performed by re|solution staff to insure that the provider continues to receive correct reimbursement and is in compliance with regulations on a prospective basis. In addition to the benefit of the revenue and reimbursement review that results in improved reimbursement, all EOBs and RAs are scanned and indexed for retrieving by the facility for follow up, HIPAA and other purposes.
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