6 Hidden Gems to Resolve Denied Claims. PrognoCIS EHR & TriZetto Provider Solutions

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1 6 Hidden Gems to Resolve Denied Claims PrognoCIS EHR & TriZetto Provider Solutions

2 PrognoCIS & TriZetto Partnership More Than A Great EHR PrognoCIS EHR and TriZetto Provider Solutions have partnered together for the past 8 years to improve claims processing and reduce your denied claims.

3 Subject Matter Experts Kristen Nehk Director of RCM Services PrognoCIS EHR Courtney McCraine National Account Executive, Sales TriZetto Provider Solutions

4 6 Hidden Gems of Practice Management 1. Electronic Remits 2. PaperResolve 3. Statements/BillFlash 4. Eligibility Checks 5. Denial Management 6. Auto-Claim Creation Additional time for Q & A time permitting * Some are add-on features, ask TriZetto for pricing when calling to set up.

5 1. Electronic Remits Electronic Remits reduce paper volume, scanning time, and data entry time Remits are available as soon as TriZetto receives them Preview remits before payment is received from the insurance carrier Set up account with TriZetto/Clearinghouse to add Electronic Remits feature Kristen to Demo

6 2. PaperResolve Automated posting of EOB forms Saves 60% in processing costs per claim Set up account with TriZetto/Clearinghouse to add the PaperResolve feature (TriZetto Contact on last slide) Drop scanned.pdfs in PaperResolve Folder to Scan paper EOBs and convert to electronic format Kristen Demo in PrognoCIS

7 3. Statements / BillFlash Monthly one-click resolution of bills and address updating Send statements electronically or by print & mail with the BillFlash feature Set up account with TriZetto to add BillFlash feature (TriZetto Contact on last slide) Contact PrognoCIS support to get one-time automatic setup configured in EHR Courtney Presenting in BillFlash

8 4. Eligibility Checks Increase claim acceptance rates Comprehensive eligibility request screen Contact TriZetto to add Eligibility feature Contact PrognoCIS for setup Kristen on-screen demo

9 5. Denial Management View each denied claim within the PrognoCIS Practice Management software Resolve payments quicker No Contact needed with PrognoCIS for setup, all handled by how remits are posted Kristen demo in PrognoCIS

10 6. Auto-Claim Creation Provider documents patient visit manually or via templates that can code for them Provider signs encounter Claim is auto created for billing Contact needed with PrognoCIS support to setup the Auto-Claim creation property and to add Encounters without Claims reports Kristen to demo in PrognoCIS

11 PrognoCIS Revenue Cycle Management PrognoCIS RCM Services : Process your patient statements Perform your eligibility checks Touch all your claims by day 30 Post updates on payments and denials Provide reports on denials, AR, and industry standards

12 Bizmatics Special Holiday Offer Participate in an EHR demonstration or sign up for RCM services before December 20th and automatically be entered in a raffle for an HDTV Visit our website at to schedule your demo today

13 Trizetto Promotion TriZetto Promotion: One month free for new clients on claims / remit services One month free for existing clients on selected products

14 Questions / Answers 1. What s involved in setting up a paper remit? 2. For Eligibility do you connect with all payers? 3. How long does it take to set up BillFlash?

15 Contact Information TriZetto phone: (314) PrognoCIS RCM Services phone: (877) PrognoCIS Support phone: (408) Thank You!