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Hospital Solutions

Our revenue management solutions for hospitals and other healthcare facilities focus on three important concepts: 

  • Determine eligibility before service is provided

  • Submit error-free claims that will be paid when presented

  • Simplify clean claim submission with a “one-click” electronic solution

  • Approximately 6% of all healthcare claims are denied due to ineligibility. More than half are impossible to recover and result in financial loss. Our ProIdentify™ online eligibility product allows providers to determine a patient’s eligibility before service is provided, within seconds over any web browser. ProIdentify supports single or multiple patient requests in real time or batch. Payer information is decoded into plain English. An entire patient schedule can be processed within minutes. The result is a significant reduction in unrecoverable claims denials and write-offs.
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    Approximately 25% of all healthcare claims are denied due to claim preparation errors. There is no value to a claim that is accepted for adjudication and ultimately denied. Competitors determine success based on claims a payer accepts for review. At Veredi we understand that your revenue is based on claims a payer not only accepts for review but pays.

    Our exceptional Pro837™ claim editor increases payment rates as never before. Pro837 uses payer-specific edits to make sure that the claim is paid on first presentation, nearly eliminating resubmissions. Within seconds, Pro837 identifies every reason that a claims file may not be paid based on all CCI/LMRP/medical necessity edits as well as published and unpublished payer-specific criteria which are updated weekly.

    Pro837’s all-payer rules engine delivers unprecedented performance, allowing providers to:
  • Achieve 98%+ payment rate for reimbursements on first submission.

  • Slash receivables and days outstanding by up to 20%

  • Accelerate revenue collection

  • Reduce denial management costs

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    Coming soon: Pro837 Denial Analytics Module™ will improve work processes by providing statistical and qualitative claims denial data used to identify information collection deficiencies and needed organizational improvements.

    Coming soon: Pro837 interface to top institutional billing systems will permit edits to be performed in Pro837 and automatically corrected in most systems (Meditech and others).

    ProClaimSubmit™ is a service available to users of our Pro837 claim editor and allows error-free claims to be submitted through our all-payer clearinghouse with the click of a mouse from the Pro837 window. 

    Advantages include:
  • Clean claims are automatically submitted

  • Secure, electronic claims submission over an internet connection

  • Automatic data formatting for every supported payer

  • Seamless connectivity to commercial and government payers  throughout the U.S.

  • Bundled pricing offers cost effective alternative to other clearing services

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