Nashville is the healthcare capital of America, home to HCA Healthcare, Community Health Systems, and dozens of other healthcare giants. Efficient revenue cycle management is critical for organizations of all sizes in this competitive market.
The Revenue Cycle Challenge
Healthcare billing is notoriously complex. With thousands of CPT codes, constantly changing payer rules, and strict timely filing requirements, even small errors can result in denied claims and lost revenue.
Our Billing System Solutions
Automated Claim Scrubbing
Our AI-powered claim scrubbers catch errors before submission:
- Missing or invalid patient demographics
- Incorrect procedure-diagnosis combinations
- Missing modifiers or authorization numbers
- Duplicate claim detection
- Timely filing deadline tracking
Real-Time Eligibility
Verify coverage before the patient arrives:
- Insurance eligibility confirmation
- Benefit and copay information
- Prior authorization requirements
- Remaining deductible amounts
Intelligent Denial Management
When denials occur, our systems help you respond:
- Automatic denial categorization and routing
- Suggested appeal language based on denial reason
- Tracking of appeal success rates by payer
- Root cause analysis to prevent future denials
Payment Posting Automation
Streamline your back-office operations:
- Automatic ERA/EOB processing
- Payment reconciliation against expected amounts
- Variance identification and alerting
- Secondary billing triggers
Integration Capabilities
Our billing systems integrate with:
- Major EHR platforms (Epic, Cerner, athenahealth)
- Practice management systems
- Clearinghouses
- Patient payment platforms
Ready to optimize your revenue cycle? Contact ZIRA Software to discuss your billing system needs.