Our rules engine does everything from medical necessity checking to proper grouping, pricing for bundled CPT codes to application of MUE rules, and split billing for your professional and technical components all of which lead to improved collections. This rules engine, combined with automated eligibility checking, submits clean compliant claims the first time greatly reducing claim denials.
TELCOR RCM processes initial claim status response information allowing you to proactively correct and resubmit problem claims without waiting for the remittance, reducing your DSO. When legitimate denials are received and claim appeals are performed, TELCOR RCM dedicates workqueues to efficiently turn around the claims for resubmission. Claim denial workqueues allow for easy corrections when information can be updated, and the claim resubmitted with tools for assignment, error categorization, easy update and batch resubmission.