DataNavigator brings together essential data analytics that assist with problem solving and provide clients with a deeper understanding of their resolutions and trends. DataNavigator provides revenue cycle analytics to our clients that identifies opportunities for improved benchmarks that are key to optimizing results.  The DataNavigator is customized by a client’s performance metrics, including internal data requirements. 

MaxPay is a customized contract management software that identifies fee schedule underpayments and erroneous PPOs. Our system generated explanation of reimbursement provides a breakdown to the payer on exactly how the payment should be calculated according to the terms of the state fee schedule or contract terms. The precise calculation leaves the payer with no feasible argument. MaxPay protects our clients revenue integrity. 

redactHIM technology ensures the electronic sweep and redaction of all sensitive information. The system automatically OCR’s and flags all documents that may contain any one of a hundred plus trigger words. This allows the HIM team to redact sensitive portions of the medical record to protect the patients private health information and reduces any unauthorized disclosures. It was built to protect the patients, and determine if there is a need for a sensitive authorization. 

PatientAssist is our patient-centered approach to assisting the patient through the complex claim process. The patient portal allows people to communicate with PROMEDICAL in multiple avenues. Patient’s are provided with a form in multiple languages, on call interpreter services and the ability to speak with a claim representative. PROMEDICAL’s expedited data collection delivers timely resolutions and patient satisfaction.   

RevCall is a proprietary technology that has mapped thousands of complex claim scenarios to drive consistent workflows, which produce clean claims and timely resolutions. RevCall optimizes every step of the process to guide the claim representatives.  The goal is to provide an exceptional patient experience, prevent errors and deliver outstanding results. 

eBilling was designed to deliver comprehensive technology strategies to provide faster and flexible means to submit claims of all types and reduce average days to resolution. PROMEDICAL partners with multiple clearinghouses to expand access to 10,000 payers. Electronic submissions for all lines of business: commercial, workers’ compensation and auto submissions.

Our Complex Claims Specialists analyze placements after they are imported into the system, using various tools and services to gather the necessary data to create a streamlined clean claims process. Other essential revenue cycle services provided by PROMEDICAL include clean claims submission, claims follow-up, closing processes, weekly close reports, document processing, health information management and electronic medical record management.

PROMEDICAL’s Revenue Cycle Services Department serves as a partner to our clients and integrates policies, procedures and work requirements across both organizations. The Revenue Cycle Services Department core tasks include:

• Conducting monthly performance meetings and/or conference calls
• Overseeing the reporting package, ad-hoc reports and                                reconciliations
• Resolving the latest and most pertinent client issues
• Informing clients of industry changes as they occur