- Claim processing: Clemittance will allow the medical coders to review claims, justify them, and make sure that they are meeting the coding rules and guidelines in a very simple and efficient user interface. The users can easily track changes on an individual claim and validate it through the validation engine ensuring that it is technically correct and is following the providers internal and contractual rules and guidelines.
- Online Claim Verification: To help reduce rejections, Clemittance will allow users to submit the claims for online testing, report errors for each claim, and help users to fix the errors before actual submission.
- Work Force Management: Clemittance is designed with the needed process and activities to maintain productive workforce, it helps supervisors and team leaders plan work responsibilities and duties, by matching employee skills to specific tasks over time, design team and work queues, and tracking results of the work efforts
- Claim Submission and Batch Management: Clemittance support both individual claim submission as well as batch submissions, in both cases the users are not allowed to submit any unvalidated and approved claims, upon completing the submission claims change their status in Clemittance to prevent any changes ensuring the integrity of the data until Remittances advises are posted. The system will notify the users upon a successful submission and will provide summaries for each.
- Remittances processing : Since Clemittance is fully compatible with the local post offices it continually monitors it checking for any posted remittance advises, and will auto downloaded it in real time bases and will map it to the claim and change it status down to the activity level based on the received response from the insurance company, it will also notify the users with the summary of this transaction to quickly begin the resubmission process if needed with minimum time and effort needed as compared to the XML manual process.
- Manual Remit utility: is an embedded utility within Clemittance RCM designed to be used by team leaders and supervisors to correct any invalid posted remittances by the payers, the users can easily remap the claim with the corrected RA file and or use an external file to correct it.
- Denial Management: upon usefully mapping the remittance to a claim the system will capture denials and helps the user in analysing trends and identifying key issues that resulted in these denials and clearly displaying the associated denial reason descriptions and codes, this will help make informed, knowledgeable actions within those rejected areas all while maintaining the full history of the claim in all its previous iterations both record and price wise.