Sharp Revenue Tools

Eligibility Check module quickly identifies active, billable coverage and includes detailed service, co-pay, deductible, and coordination of benefits information. By utilizing the latest technology and healthcare industry expertise, we efficiently triage patients’ insurance coverage to reduce claim denials and misclassification, increase clean claim rates, and discover new payer sources, resulting in higher revenue.

The Insurance Discovery model combines the best technology with human intelligence to capitalize on every inquiry and explore every coverage option, including results with undetermined outcomes. We examine claims and clearinghouses at multiple levels to find every possible payer source.

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The Prior Authorization module accelerates the process from provider order through prior authorization (PA) adjudication, saving valuable time. Automated PA provides efficiency, predictability, and cost savings that beat the manual approach.  Coming Soon!

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Any provider or billing software vendor can automatically identify and convert an individual HICN or SSN to MBI. The MBI lookup tool accelerates what is otherwise a time-consuming, manual process and automatically facilitates clean claims and optimum reimbursement.

Demographic Verifier evaluates provided patient demographic information for accuracy by verifying or correcting patient name, address, date of birth, and phone number in real-time or batch processing. In addition, we will find any missing data points which, in turn, increases Insurance Discovery hit rates and lowers your returned mail. Available in real-time or batch processing.