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Pre-certification reduces claim denials and enhances the revenue cycle.


Pre-certification

What is it?
An automated tool that enables the user to quickly and easily determine if a patient requires pre-certification before a clinical procedure is performed.

Why do I want it?

  • Reduce denials due to lack of pre-cert
  • Interface to any Registration system
  • No re-keying of data
  • Eliminate need to route face sheets to pre-cert area
  • Eliminate errors due to misapplication of pre-cert requirements
  • Alert user of uncovered services
  • Alert user that patient should have physician generated preauthorization form
  • Easy to use web-based interface
  • Audit reports to assure authorization is received
  • Automate using X12 278 transaction where available
  • No hardware to purchase
  • Easy implementation

How does it work?
At the time of registration, insurance and service information is compared to pre-cert rules. If a pre-cert is required, the record is logged automatically on a worklist. If additional information is required to determine pre-cert requirements, the registration clerk is presented with a dialog box. The worklist is populated in real-time as pre-cert requirements are evaluated. The worklist is then used to facilitate documentation of the pre-cert.

How do I get more information?
Send an email to info@nebo.com
Call Nebo Systems at 630-916-8818



 

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