eBooks: Challenging Reimbursement in Healthcare Claims Payments With Source

When it comes to handling reimbursement, dealing with incorrect payments caused by inaccessible pricing data and disjointed payment solutions can be a significant issue. This can end up costing health plans a lot of time and money. HealthEdge Source (Source), a next-generation prospective payment integrity solution, addresses these challenges with its advanced software. It helps improve accuracy, reduce rework, and enhance the financial performance of health plans.

The capabilities of Source start with providing accurate and up-to-date data through customized content libraries that cater to the specific requirements of each health plan. With over 20 years of experience in Medicare and CMS payment policies, Source guarantees that reliable data is accessible right from the start. This proactive approach eliminates the necessity for extensive manual processes and reduces payment errors.

Key Features of Source Include:

• Accurate Data Management: Source's research, policy, and data teams continuously monitor and update content to comply with changing regulations, ensuring that health plans receive the most current and actionable data.
• Extensive Content Libraries: Incorporating CMS, Medicaid, clinical, and third-party specialty data, Source tailors its offerings to align with specific medical policies and provider contract terms.
• Cloud-Based Infrastructure: Source offers a full-service model that includes IT infrastructure, maintenance, and support, reducing the internal IT burden and ensuring efficient content updates every two weeks.
• Interoperability: Source integrates seamlessly within an existing IT ecosystem, managing third-party connections to enhance accuracy and workflow efficiency while reducing operational costs.
• Advanced Pricing Capabilities: The platform supports complex custom pricing, regulatory payment policies, and performance analytics, enabling health plans to make informed decisions and maintain compliance.

By adopting Source, health plans can achieve improved accuracy, efficient automated workflows, assured compliance, better provider relationships, and minimal IT maintenance. Source's innovative approach to claims payment solutions fosters a synchronized ecosystem where rules and payments align across multiple claims systems, promoting agility in a complex healthcare landscape.