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Physician Solutions

TakeCharge offers physicians cost-effective, user-friendly solutions that can eliminate eligibility losses, minimize claims resubmissions and allow electronic routing to most payors.

Eligibility

Approximately 6% of all healthcare claims are denied due to ineligibility. Most of these are impossible to recover and result in financial loss. TakeCharge’s online eligibility product, provides these features:

  • Determine a patient’s eligibility before service is provided
  • Obtain results within seconds over a secure web browser, eliminating wasted staff time on 1-800 calls
  • Single or multiple patient requests - an entire patient schedule can be processed within minutes
  • Decodes and organizes payor information into plain English
  • The result is a significant reduction in unrecoverable claims denials and losses.

Claim Editing

Approximately 25% of all healthcare claims are denied due to claim preparation errors. There is no value to a claim that is accepted for adjudication and ultimately denied. Competitors determine success based on claims a payor accepts for review. At TakeCharge we understand that your revenue is based on claims a payor not only accepts for review but pays.

Our TakeCharge claim editor increases payment rates as never before. The TakeCharge claim editor uses payor-specific edits to make sure that the claim is paid on first presentation, nearly eliminating resubmissions. Within seconds, the TakeCharge claim editor identifies every reason that a claims file may not be paid based on all CCI/LMRP/medical necessity edits as well as published and unpublished payor-specific criteria which are updated weekly.

TakeCharge’s all-payor rules engine delivers unprecedented performance, allowing providers to:

  • Achieve 100% payment rate for reimbursements on first submission.
  • Slash receivables and days outstanding by up to 20%
  • Accelerate revenue collection
  • Reduce denial management costs

Claim Submission

TakeCharge provides a service available to the users of our TakeCharge claim editor that allows error-free claims to be submitted through our all-payor clearinghouse with the click of a mouse.

Advantages include:

  • Clean claims are automatically submitted
  • Secure, electronic claims submission over an internet connection
  • Automatic data formatting for every supported payor
  • Seamless connectivity to commercial and government payors throughout the U.S.
  • Bundled pricing offers cost effective alternative to other clearing services
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