
Adeptia is one of the few single-platform complete integration vendors whose focus and offerings remain focused on integration.
Peter Mueller
Leader, Global Business Analytics, Lonza PharmaBiotech
Adeptia’s healthcare solution can identify and correct claims errors before they are processed.
Increase your organization’s clear rate by identifying and correcting claims errors before they are processed. Adeptia supports human workflow that allows your business users to quickly identify, correct, and resubmit claims in minutes.
Together, Adeptia’s solution allows you to unlock millions of dollars in claims that traditional solutions lose sight of.
Vendors that provide billing clearinghouse solutions to Payers and Healthcare providers often do the client data processing manually or hand it off to IT. The problem is two-fold: 1) they limit the amount of service vendors can offer and; 2) this creates a huge backlog of claims that go untouched for months. Vendors get paid from the client when HIPAA 837 Claims information is successfully sent to the Payer, and processing errors delay revenue. Adeptia’s Claims Onboarding Solution enables healthcare providers the automation required to receive Claims from the clients, apply business rules, and send valid claims to the Payers.
Adeptia’s Claims Onboarding Solution automates and accelerates your billing processes which are often obstructed by data integration challenges that requires IT rather than business to fix these claims — such as getting the data from backend systems, understanding the errors, and applying business rules to fix them before sending them to Payers. And all these tasks require weeks of back-and-forth iterations between IT and Business to resolve these issues, which further delays revenue. The key reason for this disconnect is that organizations often choose a technical tool to fix what is essentially a business problem. IT custom codes or uses a very technical “engineering centric” toolset (that only they know how to use) in order to fix the data errors, and the code needs to be constantly updated and retested whenever a new set of data exceptions or a specific Payer related issue are encountered.
Backlogged HIPAA 837 Claim applications that require corrections related to incorrect Social Security Numbers, incorrect Provider IDs require different validation rules that business typically requests IT to perform which takes weeks or months to fix. Validation rules can be per client or type of message. The tasks related to managing Claims processing becomes an IT function rather than a business function. Additionally, the schemas of the HIPAA 837 Claim may need to be tweaked for a particular Payer to handle their custom field or a segment.
Adeptia is one of the few single-platform complete integration vendors whose focus and offerings remain focused on integration.
Peter Mueller
Leader, Global Business Analytics, Lonza PharmaBiotech