Predictive Analytics – Optimization – Performance Management

Unlock 835 Remittance Files and 837 Claim Files with Blue Line RCM

HIPAA mandates payers utilize the 835 EDI Standard when transmitting electronic remittance advices and providers utilize the 837 EDI Standard when transmitting electronic claims.  The intent of this legislation was to promote widespread use of EDI improving efficiency, productivity and reducing administrative cost while recognizing without “Standards” Healthcare Providers, and Patient Accounting systems could be required to support unlimited formats resulting in unintended consequences.

835 remittance files and 837 claim files are the only standard, common source of detailed “claim to payment information” regardless of provider, payer or system. Most Healthcare Systems utilize multiple Patient Accounting Systems, which provide basic reporting capabilities. Efforts by Healthcare Systems to develop comprehensive “claim to payment analytics” are cost prohibitive and typically fail to achieve their intended goals.

Unlocking 835 remittance files and 837 claim files is the only cost effective approach to provide detailed patient clinical, operational and revenue cycle analytics.

Blue Line developed RCM to provide healthcare providers a cost effective solution utilizing 835 remittance files and 837 claim files to analyze “claim to payment information” with Advanced and Predictive Analytics.

Blue Line’s RCM will benefit healthcare organizations with:

  • Prebuilt Predictive Models, leveraging statistical models and methodologies to uncover clinical, operational and reimbursement trends across millions of records not easily uncovered by traditional analytic tools.
  • Prebuilt Databases to organize and optimize the data contained in 835 Remittances files and 837 Claim files for Analytics and Reporting
  • Prebuilt dashboards, reports, analytics  and metrics

Blue Line’s RCM with Advanced and Predictive Analytics is available immediately, directly from Blue Line. To start your 90 Day Free Trial register below….

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For more information on Blue Line’s Healthcare Industry Expertise in Predictive Analytics click here.