EDI Transactions

E*HealthLine’s Payer Solution is a proven provider of claims, payments and fraud and abuse management, that increase efficiencies through intelligent transaction services. E*HealthLine helps healthcare payers streamline processes and reduce administrative costs, while lowering the overall cost of healthcare.

 

Payers Solutions

 

  • Improves payment processing efficiencies and lowers administrative costs
  • Transforms data into business intelligence, providing informed decision making for managed care delivery and business performance
  • Streamlines the claims payment cycle resulting in measurable costs savings and improved provider relations
Improves payment processing efficiencies and lowers administrative costs

 

Physician Solutions

E*HealthLine’s Certified Electronic Health Records applications, “Phoenix©” and “ISIS©” provide a web-based solution that simplifies day-to-day operational task for physician practices, by integrating eligibility and benefits verification, claims and payment management, while  incorporating  “Meaningful Use Applications  to qualify for government incentives.

 

The use of E*HeathLine’s  innovative reporting, analytics and payment tools enable the  monitoring of revenue cycles at all times, and assist the client in qualifying for government stimulus funding.   E*HealthLine’s suite of applications allows physicians to spend extended and vital time with patients, by offering electronic solutions that eliminate manual processes and paperwork. 

 

Hospital Solutions

 

Claims Submission
E*HealthLine® provides a single source for submitting primary or secondary claims, electronically or on paper. The company offers comprehensive institutional claims processing and enhanced claim edits.

Electronic Primary and Secondary Claims
All electronic transactions are conducted in real-time, enabling the ability to immediately correct and resubmit claims data with the click of a mouse. In addition, every claim is scrubbed and processed.  E*HealthLine’s Web-based and interactive platform enables its community of users to benefit from a full cycle of connectivity. 

Features:

  • Claims Scrubbing and Editing
  • Submission and Tracking
  • Rejected Claims Management

Benefits:

  • Increased Volume of Claims Processed with enhanced Operational Efficiency
  • Enhanced Profitability
  • Lower Administrative Costs
  • Reduce A/R days
  • Complete Tracking of Claims
  • Identify and Eliminate  Procedural Billing Errors
  • Timely Claims Payments

Revenue Cycle Solutions

Intelligent. Connected. Simplified.

E*HealthLine is a leading provider of Intelligent Revenue Cycle Solutions and advanced technology, facilitating the required process for hospitals and health systems to maximize revenue and profitability.

E*HealthLine’s end-to-end solutions and innovative technology, enables direct connects to all-payer networks of commercial and government health plans nationwide. The company provides comprehensive eligibility and benefits verification, as well as submission for remittance and payments of medical claims.  The direct connections provides a broad array of transactions, real-time response, extended content and advanced editing solutions,  designed to increase payments and enhance overall profitability. The company also provides a full range of integrated solutions, including online patient billing and payments, cashiering and lockbox services.

Electronic Remittance Advice (ERA)

The process of receiving and posting both electronic and paper payments from insurers electronically, enable practices to realize significant time and cost savings.

E*HealthLine’s® Electronic Remittance Advice (ERA), automates the process of receiving and posting payments from participating insurance companies.

ERA Claims Processing Benefits:

  • Accelerates payment processing and supports the capture of vital data
  • Automatically post ERA to E*HealthLine’s HIPAA Compliant Practice Management Systems
  • Ability to view and download secure ERA data from E*HealthLine’s data repository 24/7
  • Reduce or eliminate data entry errors
  • Acquire valuable outcomes  accessed through a seamless network of integrated data

Patient Statements

E*HealthLine ExpressBill Services
Provides clear and concise patient statements that leverage existing financial data to create an effective patient infrastructure.

Patient Online Payment Management
E*HealthLine's self-service patient applications, provides comprehensive and secure online billing and payment management.

Patient Connect
An innovative suite of print and eCommerce solutions that facilitate provider-patient communications

Collection Letters
The system generates and delivers collection letters for pre-collect and final notice letters, all customized to meet with each specific need.

Denial Management

Denial Management Overview

The timely collection of accounts receivable revenue is critical to a practice’s financial health.  Effective denial management is critical. The majority of denials can be effectively prevented and/or the revenue recovered by categorizes and tracking vital claims data.

  • Improved receivables cycle
  • Increased reimbursements
  • Improved cash flow
  • Reduced A/R days
  • Reduced claim rejections and denials
  • Increase productivity and staff efficiency with intelligent workflows
  • Reduced labor costs
  • 24/7 access to remittance for printing EOBs to attach to claims for secondary payers
  • Simple electronic secondary filing
  • Match remittance with the originating claim
  • Places secondary claims into a work queue for submission to payers
  • Improved management reporting and analytics

Denial Management

  • Categorizing all payer denials expedites the process of identifying and targeting problem areas impacting the bottom line
  • Enables the viewing and printing of the mock EOB for all payers and the utilization of filing secondary claims
  • Denial management’s workflow is based on denial categories, providing comprehensive reporting

Appeal Letters

Efficient printing of appeal letters provide pre-populated claim data prepared for disbursement to the payer. E*HealthLine’s appeal letters range from generic reconsideration to specific categorical documents.

The addition of an automated appeal letter featuring the ERA Filing Cabinet, accelerates the movement of  manual claims processing and  compliments the existing E*HealthLine diagnostic tools, creating efficient receivables management..

• Identify claims and create appeal letters utilizing an imbedded appeal process.
• Facilitation of timely and efficient pre-populated appeal letters.
• Ability to customize the appeal letters utilizing editable fields.

Referral Management

Interactive Care Management Solutions

E*HealthLine’s Interactive Care Management Services leverages the company’s existing electronic connections to provide clinicians with c are intervention strategies. The company’s industry-leading electronic healthcare information network, distributes healthcare communications to millions of patients both domestically and internationally.