Seamless Integration
Billing, Scheduling, Reporting seamlessly integrated with our state-of-the-art Clearinghouse and with MediTouch EHR®
Need to Find a Claim? Search by:
- Patient Name
- Member ID
- Patient Account Number
- Provider Name
- NPI
- Payer Name
- Date of Service
- Created Date
Reject Management
When the member is eligible and the payer recognizes the provider, over 99% of all HealthFusion® claims that sent to payers are accepted by those payers for adjudication.
At HealthFusion®, we work very hard to optimize your claim prior to payer submission, but inevitably the payer will reject some claims. The most common causes for payer rejection are eligibility- or provider ID-related. Not every payer makes their eligibility transaction available for automatic checking, and not every office utilizes HealthFusion’s® automatic eligibility check feature. Sometimes, payers cannot recognize a provider because they are unable to crosswalk that provider’s NPI number (National Provider Identification Standard) with a legacy ID or Tax ID, and the list goes on.
Since we know that some claims (albeit very few) will be rejected by payers prior to adjudication, HealthFusion® endeavors to make sure that your practice is notified and understands the cause of the rejection.
Every Rejection Is Matched to One of the Following Reject Categories (When Appropriate)
- Coding
- Dates
- Duplicate Claim
- Eligibility
- Payer
- Provider.
By classifying rejections by category, it is straightforward for your office to interpret the reason for a payer rejection, and HealthFusion® can assist your office with reports that explain which type of rejection is the most common in your practice.
HealthFusion’s® Claims Angel® Program Takes Reject Management to the Next Level
The Claims Angel® Program from HealthFusion® automatically monitors the HealthFusion® system and sends your office a customized email for each payer rejection that can be mapped back to a specific claim. No need to wait until your next log in to learn about a claim rejection. An easy-to-interpret email with a link to a help screen on how to fix the rejection will be sitting in your email Inbox as a reminder to manage the rejection in real-time!
Since we know that some claims (albeit very few) will be rejected by payers prior to adjudication, HealthFusion® strives to make sure that your practice is notified and understands the cause of the rejection.
As part of Claims Angel®, you never have to worry about whether a claim has been acknowledged by the insurance payer. If a certain payer has not acknowledged a claim within a given period, our award-winning Customer Service Team will be calling that payer to determine status and get the claim acknowledged as soon as possible, saving your office the time on the phone and interaction with the payer.