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  • Revenue Performance

    Empowering providers to optimize the entire revenue cycle. We offer the insight, workflow management, personalized engagement, and services to ensure providers optimally collect from patients and payers.
    • Patient Access Advisor

      Automate workflows to improve financial clearance

      Patient financial clearance is critical to reducing denials and getting paid faster. Patient Access Advisor provides eligibility and benefits verification, patient responsibility estimation, address validation, healthcare risk-scoring, registration quality assurance, automated pre-authorization, custom work queues, and Medicare medical necessity evaluation. It also has the ability to take patient payments, anywhere at any time.

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    • Revenue Discovery Advocate

      Analytics and technology-enabled professional services

      Revenue Discovery Advocate solutions optimize reimbursement with advanced analytics, proprietary technology, and expert staff. We offer audit and recovery services, outsourced accounts receivable management services, underpayments and denial recovery, and reporting. Utilize this portfolio of tools and our team of experts to capture and recover revenue and prevent leakage while improving processes with keen analytics insights.

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    • Coding Advocate

      Outsourced coding expertise for providers

      Coding expertise is essential for your organization’s timely and accurate reimbursement. Strengthen your reimbursement with a variety of coding capabilities and outsourced staff who are highly skilled in ICD-10 and specialty coding. Change Healthcare delivers comprehensive facility and professional fee coding, audit, and Clinical Document Improvement (CDI) services. These client-centric services cover every specialty including inpatient and outpatient facilities, and virtually meet any volume need.

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    • Claims & Denials Advisor

      Gives visibility into claims, remits, and denials

      Claims and Denials Advisor is an intuitive, cloud-based solution that integrates with your hospital information system, practice management system, and accounts receivables system to increase clean claim rates, manage the denials process, and reduce receivable days. You’ll see increased staff productivity and streamlined claims submission and denials management processes. You’ll also gain insight into your operational performance to help optimize payer collections and drive revenue.

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    • Remittance Advisor

      Automates payment processing and posting

      Remittance Advisor is a complete solution that facilitates, expedites, and automates payment processing and posting activities. The solution components include Healthcare Lockbox, EOB Conversion, Funds Verification, Posting Enrichment, and Correspondence Processing. These services help reduce costs and improve efficiency in your billing office processes.

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    • Receivables Advisor

      Consumer-friendly patient billing and payments

      Receivables Advisor simplifies each step of the payment process, empowering you to collect more patient payments, get paid faster, and reduce both your cost to collect and patient write-offs. Receivables Advisor drives patient payment before, during, and after the encounter by personalizing communication and making the process easier for patients to understand. In addition, our bundled merchant service lowers your costs and improves revenue performance.

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  • Network Solutions

    Connecting providers, payers, pharmacies, and patients with the nation's largest health information networks for eligibility, claims, remittance, and payments.
    • Referral Authorizations

      Automated referral and authorization transactions

      Our Referral and Authorization Network facilitates automated referral and authorization transactions and communication to the benefits workflow, allowing providers to directly confirm the authorization of services. Streamlining these transactions through our Referral and Authorizations Network can help to reduce operational burden and costs. The healthcare services review transaction includes prior authorization, specialty care, advance notification and referral.

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    • Eligibility and Benefits Verification Network

      Delivers electronic patient eligibility information

      Change Healthcare patient eligibility capabilities streamline provider workflows with accurate, timely, and relevant benefit information from the largest group of commercial and government payers in the industry. We offer advanced patient eligibility that delivers standardized, specialty-specific eligibility and benefit information to practices that is easy to use and directly interfaces with other health information and practice management systems.

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    • Claims and Remittance Network

      Electronic transmission of claims and remittance processing

      Our extensive Intelligent Healthcare Network™ offers hospitals and physicians easy-to-use electronic claims processing and remittance advice. Claims are securely transmitted in HIPAA-compliant formats from provider to payer for receipt and payment. Automation is streamlined with advanced edits that help ensure accuracy and reduce costs. Our nationwide electronic network reach allows us to connect to virtually any practice management system.

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    • Clinical Network

      Facilitates clinical information exchange between labs, providers, and other ancillary services

      Clinical Networkis an intelligent system facilitating end-to-end information exchange between labs, providers, and other ancillary services. It provides streamlined connectivity and tools to deliver electronic orders, results, and prescribing. This includes electronic prescribing of controlled substances (EPCS) and a certified portal to help qualify for Meaningful Use. With 600+ labs/hospitals and has over 90 fully integrated Electronic Health Record (EHR) connections, Clinical Network will accelerate your prescription ordering and routing.

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  • Coverage Discovery Solutions

    Our patient eligibility and enrollment services for government programs, exchanges, self-pay patients and third-party coverage. Trained experts help patients enroll and provide financial counseling services.
    • Self-Pay Coverage Advocate

      Medical eligibility and enrollment services

      Our Self-Pay Coverage Advocate service helps drive down uncompensated care by identifying coverage for self-pay patients, regardless of your state's participation in Medicaid expansion. Our onsite staff consults with patients to determine their potential eligibility for enrolling them in government funding sources at the federal, state, and local levels to secure payment for accounts that would have otherwise resulted in uncompensated care.

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    • Third-Party Coverage Advocate

      Third-party liability revenue cycle management

      Our Third-Party Coverage Advocate service manages reimbursements from motor vehicle accident and workers’ compensation claims. The service includes onsite professionals and back-office teams who handle patient interviews, documentation, investigations, billing, and claims management. Our team reduces confusion about claims and the billing process, decreasing or eliminating patients’ out-of-pocket expenses while increasing your hospital's revenue.

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    • Financial Counseling

      Educates patients on their financial options

      Our Financial Counseling collects patient payments pre-service and at the point of service. The process includes confirming eligibility and insurance verification, identifying coverage sources, communicating financial responsibility, establishing payment plans in accordance with provider policies, and collecting and processing payments. After implementing our solution, our clients see collected patient payments rise significantly.

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