VERICLE FACILITATES MEDICAL BILLING WITH FIVE KEY COMPONENTS

Claim Validation provides both pre-service and pre-submission claim validation. Pre-service validation includes demographics and eligibility and pre-submission - eligibility checks, Local Medical Review Policies (LMRP), Correct Coding Initiative (CCI), or payer-specific edits. It flags invalid claims and explains the errors for on-line editing using on-line HCFA form before submitting to payer, thereby dramatically reducing days in Accounts Receivable.

Billing Workflow (Straight Through Billing engine) expedites payments by enabling simultaneous processing of multiple claims and includes electronic claim submission, digital payer response reconciliation, rule-based claim classification into separate work queues for efficient follow-up task allocation according to error codes or payer/provider id, and personnel productivity tracking.

Patient Billing includes patient scheduling and accounting, as well as data integration with Patient Statement/Collection Letters and export to collection agencies.

Accounts Receivable Management includes balance calculations based on contract charge amounts, close of month, payment distribution and posting, collections, and interactive profitability analysis.

VericleDirect™ provides secure web-based access for both providers and patients. Providers analyze office profitability, review claim status, and interact with the billing office, while the patients query their accounts for outstanding payment status and processed claim history.