Most hospitals use a back-end claims scrubber or clearinghouse designed to help you reduce your denial rate, but many of these scrubbers just don’t work. The problem—scrubbers and clearinghouses are not updated immediately when payors update their rules, and the scope of their edits does not match the payors'. If you are currently using a claim scrubber or clearinghouse, switching to Comply.Net could significantly decrease your claim denials and catch more errors.

Comply.Net is a powerful claims editor that you will never have to house, maintain, or update because it’s web-based. Comply.Net uses HIPAA compliant electronic data interchange to receive the claims, and then uses a fully automated, expert auditing engine to uncover potential billing problems within minutes of submission. Claimtrust updates Comply.Net every week, and Comply.Net matches the payor’s rules edit-for-edit (over 100 million edits per claim).

Reduce your denial rate to under 2% and have the reports with the right information in-hand and on-demand.

Edit better, faster, and smarter
Data transmission is secure and 2006 HIPAA compliant. Comply.Net puts your claims into a database and immediately begins to edit your batch claim-by-claim, using the same edit list that your payor would. Our clients have experienced yearlong payment rates over 99.5%.

You are able to maintain a high payment rate because we stay up-to-date. While other companies update their system monthly or even annually, we update every rule every week. If a critical update or correction is issued, we update the same day.

The 100 million plus edits that Comply.Net runs for every claim include Ambulatory Payment Classification edits as well as all Outpatient Code Editor edits. Comply.Net also ensures the correct processing of claims under the provider’s Outpatient Prospective Payment System. Comply.Net edits all standard claim formats (837, UB-04, UB-92, HCFA1500, etc.) as well as customized formats, checking for duplicate claims and primary re-bills, including submission of corrected claims on an incorrect form.

Track and document your revenue cycle
Comply.Net’s SQL architecture creates timely reports from a variety of criteria, including—

• A medical necessity error report that helps you to discover which CPT and ICD-9 codes most frequently fail medical necessity, giving you the information you need to educate your staff and providers.
• A failed CPT summary that helps you to identify lost revenue trends, and to learn which departments have coding problems with certain procedures.
• A summary report that contains a high-level summary of failed edits for any specified time period, along with the failed edits’ cost.

No on-site implementation, installation, or maintenance is necessary so no lengthy set-up costs are either. We are confident that Comply.Net will help you to catch more errors, minimize claim denials, and to identify, document, and eliminate revenue leaks.