Automated Payment Auditing System
The MGMA states, and most practices have found, that between 4 and 6 percent of a practices revenues are under paid by payors. This is money your practice does not even know you are missing, because the EOB states an inflated adjustment amount, thus your practice management system often times shows a zero balance! DataPlus finds these underpayment automatically and effortlessly, with the need for time consuming "spot checking".
Posted payments from the primary insurance carrier are matched against contracted fee schedules maintained within DataPlus®. Payments that are not paid according to the fee schedule are placed in a paperless collection system so your staff can easily file low payment appeals. There is no paperwork to shuffle, everything is on screen in an easy to read format. The payment auditor or collector simply pushes a button, selects the appeal letter to send and waits for payment. If payment is not made within a pre determined time frame, the claim appears again for automated paperless follow-up.
Because DataPlus automatically handles modifiers that increase or decrease the allowed amounts, and our system automatically ranks multiple surgical procedures for discounts, you can be assured that we catch every single underpayment, no matter the size!
The DataPlus ®Automated Payment Auditing System audits from the start of any contract regardless of when the contract was established in the system, and auditing goes backwards as far as your data will allow.
Auditing and appealing low payments is extremely fast and easy, using the audit screen shown below. Virtually all the information the collector needs is at their finger tips to appeal the claim with a touch of a button. Appeal letters are automatically printed at the end of the day.
