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Summary

One of the many challenges in the healthcare revenue cycle management process is reconciling claim remits against cash received. Inefficiently managing this process can create widespread issues across the finance, cash management and claims processing business units.

CARS can help you better manage this process while providing tight integration to your existing claims processing and financial systems.

Business Needs

When the reconciliation process fails or is delayed, each business unit involved is impacted in a unique manner. The ability to efficiently manage and reconcile cash receipts is critical. The system must:

Validate incoming data sources for errors
Handle data format discrepancies among payers
Provide adequate reporting and processing status
Support quick addition of new payers, business units, and payment sources
Facilitate reconciliation between incoming payments, posted transactions, and General Ledger entries

These address the core processing needs of the reconciliation system. Additionally, the system must:

Reside on a robust operating platform
Scale to allow for future growth
Operate securely and efficiently

Business Process

Prior to sending 835 claims remit files to backend billing systems for processing; the files are reconciled with payments received. Remits can be split between multiple back-end systems as business logic dictates.

CARS manages claim remit and payment discrepancies, providing management tools and reporting to alert and address processing issues.

After cash posting is complete, CARS validates posting the batch totals and provides cash posters the tools to balance deposits and assist in manual posting where required.

Through the CARS Finance Portal, the Accounting group is able to generate month-end cash related journal entries and complete reconciliation activities related to Cash Receipts and Cash Posted.

Benefits

Front-end validation, duplicate checking, and error handling of 835s
Automated association of 835s to payments
Ability to split 835s between disparate back-end systems
Deposit Reconciliation / Batch Verification
Electronic handling of intercompany / non-patient A/R transactions
Acceleration of cash posting process to provide same day posting of receipts to patient accounts
Provides management tools and reporting to alert and address processing issues
Financial reporting of posted / unposted cash transactions
Implemented without requiring modifications to existing systems
Fewer resources required to manage cash posting process

LogiSolve’s Approach

LogiSolve uses a light-weight project management methodology on top of an iterative development approach. Our approach to software development builds quality assurance into the construction process, producing thoroughly tested solutions at the unit, module and system level. LogiSolve's success as an organization is a tribute to its adherence to its principles toward clients, employees and quality.


CARS Processing


(A)  CARS retrieves 835 claim remits from clearinghouse and submits to Reconciliation Engine
(B)  Cash transactions retrieved from interface to bank
(C)  Association Engine associates claim remits to payments
(D)  Reconciled 835s are sent to appropriate back-end system(s)
(E)  Cash posters manage unbalanced deposits
(F)  Finance Portal provides tools for creation of Journal Entries and Reconciliation

 

LogiSolve, LLC. • 600 Inwood Ave N • Suite #275 • Oakdale, MN 55128 • 763.383.1000
www.logisolve.com

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