Transaction Exchange
Advanced Clinical Editing
Edits sourced from the Ingenix
ClaimsManager ™ knowledgebase
By reducing denials, decreasing
rejections, and accelerating
the accounts receivable cycle,
Ingenix Advanced Clinical
Editing helps you to maximize
revenue potential.
Integrating a sophisticated claims editing service into your
practice may have been out of reach. Until now. The Ingenix
Advanced Clinical Editing service is a powerful and proven
tool that enables Ingenix Transaction Exchange clients
to review claims before submission to payers in order to
reduce claim denial rates, shorten accounts receivable
cycles, and increase the rate of collection.
Ingenix Advanced Clinical Editing is
integrated into the Ingenix Transaction
Exchange clearinghouse so it's easy to
implement, easy to use, and available
with affordable subscription pricing.
This rules-based, front-end clinical
editing tool offers a robust rules engine
and some of the most sophisticated
database editing functionality in the
marketplace to help you:
„ Decrease rejections and denials by pre-
screening for billing and coding errors
„ Identify partially billed or missed
charges
„ Maintain compliance with new and
changing regulations
„ Reduce administrative expenses and
speed revenue stream
Increased revenue
potential
As your claims process becomes
more streamlined, you may reallocate
personnel to other revenue enhancing
areas. The front-end and review
capability of Advanced Clinical Editing
enables you to pre-screen your
claims for billing and coding errors
and avoid the delays associated with
incorrect coding. Because Ingenix
Advanced Clinical Editing is powered
by an extensive knowledgebase
with more than nine million coding
relationships, including both Medicare
and commercial coding, the increased
accuracy helps you receive appropriate
and timely reimbursement.
Intelligent automation
Advanced Clinical Editing is integrated
within the claims submission and claims
management Transaction Exchange
work ow process so it's easy to use.
This new service helps providers
submit cleaner and more fully coded
claims— ultimately enabling faster
capture of more revenue. Advanced
Clinical Editing helps reduce the risk of
non-compliance with federal guidelines
with automatic alerts that provide
opportunities for ongoing education of
your coding, billing, and clinical staff.
If you're a vendor partner, you will be
able to extend these same benefi ts to
your customers that use our Transaction
Exchange EDI services, adding
substantial value to your application.
Flexible interface
Advanced Clinical Editing interfaces
directly with Ingenix Transaction
Exchange, allowing you to edit charge
transactions line-by-line, in real-time,
prior to posting them. You also have the
option to edit the claim in a batch-mode.
This direct interface translates into a
more effi cient work ow and, ultimately,
an improved revenue cycle.
IndustryTechnology
AverageEnabled
Reducing Your Resubmission Cost
Rejection/denial rates— Up to 15 percent of
claims are rejected or denied, necessitating
rework and resubmission. Imagine the
reductions in your administrative costs if
you could reduce this to only 5 percent.
