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Claim Status Verification and Notification

Empowered Business Office ClaimStatusPlus

Recondo's Empowered Business Office (EBO) ClaimStatusPlus™ automates the process of obtaining claim status directly from the payer, significantly reducing the manual effort by staff in the hospital business office, and significantly reducing the hospital's cost to collect.

Automating the Process

EBO ClaimStatusPlus automates the process of retrieving the status of open claims, allowing hospital staff to segment claims conforming to the specific process adopted by each hospital. Hospital staff then work each claim by various priority standards.

The EBO ClaimStatusPlus service can work with current standard HIPAA-specified electronics transaction types, 276 (Claim Status Request) and 277 (Claim Status Response). Under the 276/277 transactions rules, a hospital must retrieve and understand claims status during the course of adjudication. No other software service offers the capability to retrieve and manage 276/277 claims processing via both electronic transactions and ReconBot® technology accessing data from the payers' websites. EBO ClaimStatusPlus also works with the 5010 transaction types 997/999.

Saving Time, Reducing Costs

Using EBO ClaimStatusPlus, hospital staff can easily and quickly discover the status of outstanding claims, including if the payer paid, pended, or denied the claim.

In addition, EBO ClaimStatusPlus retrieves payer information for the reason a claim was delayed or denied. Using the unique Recondo Control Center Worklist, staff can sort by any field and create a variety of standard and custom reports, including the claim status based on the average days in Accounts Receivable and many more.

Direct Connects to Payers

The Recondo team has decades of experience and superior expertise in payer connectivity and transaction formatting, which streamlines payer testing and connection. Recondo services can connect to payers via HTTPS, SOAP, JMS, VPN, or in some cases proprietary connections to payers that don't have real-time eligibility transaction capability.

Recondo is CORE II-certified and has developed direct connects to numerous CORE II-certified payers, offering a flexible and technologically advanced payer connection capability that supports its Revenue Cycle Management suite of products.

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