EXPERIENCE ACCURATE ALLOWANCES AND MONTHLY FINANCIALS!
A third party payer calculation engine and adjudication system, this service includes calculating and posting the accurate contractual allowance and expected reimbursement at the time of final billing.
This service includes all contractually obligated payers; managed care, Managed Medicare, Managed Medicaid, Traditional Medicare, and Tricare.
The majority of healthcare providers currently utilise a calculation engine (contract management system). Exela’s service compliments, supplements, or replaces your existing processes at your discretion.
Exela begins the process by loading all contractual agreements, scanning, indexing, and profiling all agreements, and calculating the contractual allowance and expected reimbursement at time of final billing. Exela electronically posts the adjustment the day we receive the final bill and any adjusted billings.
A key component to a successful analysis begins with patient registration. Exela verifies the correct payer code assignment at time of final billing ensuring the correct contractual allowance is posted. Exela’s Patient Responsibilty Estimator is also included (see our additional Reimbursement Cycle services links).
In addition, Exela attaches the Account Calculation Detail in your patient accounting system, reflecting the expected reimbursement by revenue code as it appears on the bill. Exela attaches the respective actual contractual agreement to each account. These two items allow for easy access and printability.
You can utilise our professional staff of certified public accountants, registered nurses, and accountants, to shadow and adjust your existing contract management system, or we replace your existing system and become the sole service provider.
This is an ideal service to ensure correct net receivables, accurate allowance, and correct monthly financials.
Exela’s fees are a fixed monthly fee.
This service typically includes a retrospective and concurrent underpayment and recovery analysis. You may also incorporate contract modeling.
We have 2 questions:
- Would you like to experience accurate allowances and monthly financials?
- Would you like to eliminate or reassign patient accounting staff FTE’s?