Murfreesboro, Tennessee, May 26, 2009…ClaimTrust, a leading provider of revenue cycle tools and services for hospitals, today announced the availability of the InSight Revenue Cycle Solution™, a suite of fully hosted, web-based products designed to target the key inflection points in the revenue cycle to ensure that hospitals efficiently collect all of the revenue to which they are entitled. This is the first hospital revenue cycle system to offer comprehensive all-payor edits down to the fiscal intermediary (FI) and plan level as well as the ability to deduce unbilled charges and generate net new revenue – the result is a powerful suite designed to find hospitals more cash than any other solution available today.

All-Payor Edits

ClaimTrust’s comprehensive revenue cycle solutions suite offers true all-payor support while providing the industry’s deepest edit library, with payor rules down to the fiscal intermediary level for Medicare and to the individual plan level for Blues and commercial payors.

InSight Revenue Cycle Solution Offerings

ClaimTrust’s revenue cycle suite is a web-based, fully hosted solution, ensuring that all users are always benefitting from the latest version of the product and the most up-to-date payor edits. All of the products in the suite work with InSight Workflow & Claim Editor, a comprehensive workflow platform which provides powerful editing tools and intelligent routing of claims, as well as InSight Reports, a reporting and analytics module with a wide range of report and dashboard options.

Other products in the InSight Revenue Cycle Solution suite include:

• InSight Medical Necessity: Quick and easy access to the most comprehensive and up-to-date medical necessity database available. Automatically reviews and compares diagnosis codes and procedure codes with the appropriate payors’ medical necessity rules to prevent denials and ensure maximum reimbursement. Auto-generates Medicare advance beneficiary notices (ABNs) for Medicare patients.
• InSight Compliance: Scrubs all claims for clinical accuracy and coding completeness before submission, automatically updates all published and unpublished payor edits into the system. Applies clinical logic to all claims to identify harder to find incorrect codes and to deduce missing charges to generate additional revenue within the revenue cycle.
• InSight Denials: Analyzes remittance data and tracks, trends and reports on the root causes of denials. Works in conjunction with InSight Compliance to create a complete denials feedback loop that identifies new and unpublished payor edits and incorporates them into the compliance engine for a continuous improvement process that increases effectiveness and positively impacts revenue.
• InSight Payment Variance Analyzer: Coming later this year, ClaimTrust will add a payment analysis tool to the InSight Revenue Cycle suite to automatically compare 835 remittances to a hospital’s contract to catch any variances and ensure maximum payment according to those contract conditions.
• InSight RAC: Also coming later this year, ClaimTrust will add a new RAC module to its suite to organize, manage, and report RAC requests, responses, and appeals activities. Will track all data associated with RAC audits and appeals, and will manage record requests and appeals across multiple departments and locations. The built-in RAC knowledgebase will include rules, content and letter templates to ensure best practices throughout the appeals process.

“We have been working with hospitals on revenue-cycle issues for a long time, and one of the most important lessons we have learned is that if you focus on just a few critical areas you get ninety percent of the improvement for fifty percent of the time and resources,” said Joe Ferro, president and CEO, ClaimTrust, Inc. “With this new suite we have encapsulated that philosophy into a set of solutions that provide a highly concentrated boost to the hospital’s financial performance. More than that, our analysis and reporting tools enable our clients to sustain their gains by tracking back to root causes and continuously improving their processes.”

Tennessee-based ClaimTrust, Inc. has a customer base that includes more than 300 hospitals of various types and sizes across the country, ranging from rural to community to academic institutions.

To see a live demonstration of the new InSight Revenue Cycle Solution suite, please visit ClaimTrust at the Healthcare Financial Management Association (HFMA) 2009 Healthcare Finance Conference in Seattle from June 14 -17, 2009 in booth #1135.