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Physician Solutions

Veredi offers physicians cost-effective, user-friendly solutions that can eliminate eligibility losses, minimize claims resubmissions and allow electronic routing to most payors.

Approximately 6% of all healthcare claims are denied due to ineligibility. Most of these are impossible to recover and result in financial loss. ProIdentify™, our online eligibility product, provides these features:
  • Determine a patient’s eligibility before service is provided

  • Obtain results within seconds over a secure web browser, eliminating wasted staff time on              1-800 calls

  • Single or multiple patient requests - an entire patient schedule can be processed within                  minutes

  • Decodes and organizes payor information into plain English

  • The result is a significant reduction in unrecoverable claims denials and losses.
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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 payor accepts for review. At Veredi we understand that your revenue is based on claims a payor not only accepts for review but pays. 

    Our exceptional Pro837™ claim editor increases payment rates as never before. Pro837 uses payor-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every reason that a claims file may not be paid based on all CCI/LMRP/medical necessity edits as well as published and unpublished payor-specific criteria which are updated weekly.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

  • Improve work processes by identifying needed data collection improvements

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

    Advantages include:
  • Clean claims automatically submitted

  • Secure, electronic claims submission over an internet connection

  • Automatic data formatting for every supported payor

  • Seamless connectivity to commercial and government payors
  • Bundled pricing offers cost effective alternative to other clearing services

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