Health Plans
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Revenue Cycle Management
Ensuring that claims are processed effectively and efficiently is critical to health plan and provider operations. Offered as an add-on product to Provider Communication Management, Revenue Cycle Management automates the process of claims submission, tracking, adjustment, adjudication and investigation, following the claim from submission to payment. Functionality includes:
- Professional Claim Submission
- Claim Logging, Tracking and Attachments
- Institutional Claim Submission
- Real-time Claims Adjudication
- Claim Adjustment and Investigation Request, Inquiry and Messaging
- Fee Schedules
- Claim Aging Report
- COB Submission to Third-Party
- Electronic Remittance Advice (Payment Detail)
- Explanation of Payments
For more information on NaviNet Revenue Cycle Management, please contact us.