Custom Design
The appeals module was designed specifically for claims. In fact, all appeals linked to claims will appear on the claim detail page for users to see.
Letter Generation
Appeals often involve letters that need to be mailed to patients. With our templating system, these custom letters adhere to the strict Medicare standards.
Work Queues
Often, appeals are on a strict time table. In addition to tracking AR, the work queues integrate appeals so users do not fall behind.
Portal Integration
Save time by having providers start their own appeals through the portal. Providers can then track the status of their appeals.
Appeals Module
Integrated Solution
Imagine having all appeals in one searchable location. Our solution does just that. This includes all notes, letters, members, claims, and providers at the ready. No need for double-entry. No need to manually generate letters. No need to track appeals in Excel or some other system clearly not designed for claim appeals.
Some clients use only the appeals module as it can integrate with their current claims system. All the same features are implemented including custom letter templates and generation.
Letter Generation
Our custom letter template editor allows users to drag-and-drop fields onto the letter in mail merge fashion. Start from a predefined template or start a new one.
All fields are customizable including font type, size, and color. Do you have a letter with a custom letterhead? Upload images directly and position them into the document.
Having trouble with a particular letter template? Our system is capable of uploading direct templates for those extra tricky formats and standards.
Provider Initiated
Our portal has a section for providers to initiate and manage their own appeals. These appeals, once submitted, appear in case worker queues so that they may be worked in a timely fashion.
Appeals are often settled with proof of timely filing or simple case documentation. Providers can upload and have this data added without anyone needing to pick up the phone.
Appeals can also be faxed in by the providers. A custom process is waiting for these faxes, creates an appeal, and attaches the faxed pages.
