Claims Management Suite
Nebo Systems' Claims Management Suite provides hospitals and health care organizations with a complete set of solutions and services to ensure that clean claims are submitted, edits and denials are worked in priority order, reimbursements are paid correctly and payments are posted properly.
The resulting technology delivers significant claims management benefits:
- Become more effective through significant workflow improvements, automated processes and data efficiencies.
- End your reliance on multiple vendors or bolt-on, stop-gap measures to address the entire claims management process.
- Focus on your most important issues because your claims and billing processes will operate at maximum efficiency.
eCare® Claims Management System provides centralized management of the claims submission process. Claims are imported from the Hospital Information System (HIS), checked for data and coding integrity and submitted to the respective payer or clearinghouse. Nebo’s flexible architecture facilitates a high degree of customization, enabling users to include procedures specific to their situation.
eCare® Resolution Manager captures all of your bill edits and denials directly from the eCare Claims Management System and automatically routes them to assigned staff for correction in priority order based on your custom rules. All the critical information needed to work each bill edit appears in a single portal which expedites resolution. Our denials workflow completely reconciles ALL denials eliminating “black holes” and positively impacts reimbursements.
eCare® Recon is a reimbursement management solution that reconciles claims against payer payment/vouchers. Recon will locate variances by comparing what the payer actually paid to what your contract states should have been paid.
eCare® Posting solutions automate the task of manually posting payment information from your remits and other important billing information back into your host HIS. Our posting technology is fully customizable to fit your business rules and works using either using a variety of scripting and file based methods to help you save time and improve data accuracy.
eCare® RACMan helps hospitals prepare for RAC reviews by tracking all RAC activity to minimize financial risk and avoid technical denials. RACMan manages and tracks RAC complex claim reviews, appeals and underpayments. RACMan’s audit control center defines the facility type, audit type and reporting period and submits a quarterly summary file to the American Hospital Association’s (AHA) RACTrac.
Claims Consulting and Outsourcing is offered through The Cosand Group, an affiliated company of Nebo Systems. Cosand’s experienced claims staff supplies the resources and expertise you need to significantly increase reimbursements from commercial and government payers. Available for short or long term projects, Cosand will analyze your day-to-day administrative operations and provide proven solutions to your most pressing claims and billing needs.
No matter how you submit claims, Nebo’s Claims Management Suite will clean and streamline the submission process, identify and prioritize the most profitable work items and increase the revenues your facility needs to sustain its healthcare mission.