Have an issue with duplicate provider records?
Struggle with matching medical claims/ bills to your provider database?
Out of control provider not found queue?
If you answered “YES!” to these questions, trust that you are not alone. Most healthcare payers struggle with these same issues every day. Provider matching of Medical claims/ bills can be frustrating and time consuming, but manually. Matching claims is even more of a task. Having to review each one, call the provider to correct the information, hoping they answer, and if not, trusting that Google search will give you the valid information you require. This process is enough to make your head spin.
Not only is this process time consuming, it can be quite costly. According to Glenn McLellan’s Managing the Health of Your TPA… Know Your Numbers the cost per claim is $5.81 per employee per month with consideration to staffing, share of technology, receipt, fulfillment, adjustments, and office allocation cost.
Do you know your internal cost per claim?
SureHit is the innovative EDI provider matching solution developed by BASELoad, Inc. With a 99% provider matching accuracy, SureHit takes the guess work out of matching those medical claims/ bills insuring an increase to your auto-adjudication rate.
SureHit is available in batch and real-time, depending on the claims payment system being used. Clients send BASELoad their 837 medical claims/ bills either in a daily batch or through a real-time web service call, SureHit Now. Through this service, BASELoad matches the provider on the medical claim/ bill to the correct provider in their database. For those that are not matched, a new provider load record is created. Best of all, SureHit is cost effective and is only a fraction of the labor-intensive cost for manually matching, which goes straight to the bottom line.
Prior to implementing SureHit, the EDI provider matching solution, it is recommended to have your provider database cleaned. BASEload has been specializing in cleaning, normalizing and validating provider databases since 1999. During a cleanup, BASELoad runs utilities to address validate, fix/parse name fields, and inactivate duplicate providers. Do you have missing information such as Taxonomy Codes, NPIs, Phone/Fax, Medicaid, Medicare, or License numbers? Well, BASELoad can fulfill those fields with the use of our internal virtual network.
April 1st don’t be fooled into selecting the wrong provider. Let BASELoad help!
Want to learn more about BASELoad and our provider data services? Please check out our new website, send us an email at info@baseload.com, or give us a call at 704-424-9889 and don’t worry, a real person will assist you, not a machine.