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Automate Claim Status

Recondo 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

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

The 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. ClaimStatusPlus also works with the 5010 transaction types 997/999.

Using advanced and proprietary ReconBot® technology, ClaimStatusPlus automatically retrieves claims and each associated claim status from payer websites, then displays those claims in a centralized queue. The user can then sort the queue in a variety of ways to confirm processed or adjudicated claims and prioritize open claims for work and follow-up. As claims are closed, ClaimStatusPlus can interface to the hospital Billing and Patient Accounting systems.

Saving Time, Reducing Cost

Using 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, 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.