Video: Retroactive Change Manager User Interface Demo - HealthEdge Source
HealthEdge Source™ Retroactive Change Management provides a proactive approach to handling retroactive changes. We built this solution to be automatic and highly configurable, so you can easily tailor the scheduling to fit your specific needs.
Key Features and Benefits
- Automated Scheduling:
- Schedule jobs to run at optimal frequencies for your organization
- Configurable by provider types, dates, and times
- Includes an ad-hoc option for individual scenarios
- Compatibility with Bi-Weekly Updates:
- Seamlessly integrates with bi-weekly updates to capture retroactive changes from CMS or state Medicaids
- Real-Time Notifications:
- Alerts team members about job statistics, including the number of impacted claims and the amount of underpayments or overpayments
- Comprehensive Dashboard:
- Access detailed job summaries, including impacted claims
- Understand underpayments and compliance adjustments to reduce the risk of audit failures
- Identify overpaid claims for potential savings and recoup necessary dollars
- Interactive Data Points:
- Adjust based on provider type, individual providers, or percentage of change
- Export individual reports for internal use
- Claim Review and Search:
- Search and review individual claims
- Export full summaries of impacted claims, comparing production claim totals versus reprocessed claim totals
- Detailed Change Information:
- Access information on pricer and edit changes for individual jobs
- Includes resource links when available
We are continually adding to this solution. Phase two will provide even more data and detailed changes to further refine your health plan’s efficiency.
