Irvine, CA – StrataCare, LLC, a bill review software and service company, recently announced its recent deployment of connectivity with key specialty networks that will support its clients’ desire to remain compliant while generating improved medical cost savings.
StrataCare continues to invest strategically in state-of-the-art electronic connectivity with various high volume entities for quicker and more accurate loading of prospective specialty network bills through StrataWare®, its SaaS-delivered medical bill review application. Specialty network bills are medical bills received from ancillary vendors such as physical therapists, pharmacies, diagnostic imaging, durable medical equipment and home health providers. These bills, which can represent more than 20 percent of medical bills processed by a payer, are frequently excluded from the bill review process and workflow. As a result, specialty network bills often result in unnecessarily higher reimbursements.
By connecting directly to its specialty network partners, StrataCare ensures the accurate capture of all billing data, including billed amount, bill review allowances and network savings. Incoming data is validated to make sure it meets state reporting and other critical requirements before being loaded. Some of the feature-rich components associated with this latest cost containment enhancement include:
- Creation of a single, comprehensive repository for medical bill data
- Elimination of manual processing of prospective bills
- Reduction in maintenance of multiple payment file imports
- Enhanced application of business rules for capturing prospectively priced network bills
As the pioneer in web-based medical bill review software, StrataCare also utilizes industry-accepted electronic data interfaces for faster partner onboarding. StrataCare clients, which include insurance carriers, third-party administrators, state funds, self-insured employers, municipalities and managed care firms. With StrataCare’s direct connectivity to specialty networks, customers can forego the establishment of proprietary interfaces to avoid the ongoing maintenance fees, system upgrades and retesting costs associated with the exchange of electronic data. In addition, StrataCare’s enhanced connectivity:
- Provides standardized acknowledgements to ensure accurate, automated reconciliation
- Contains retrospective bills on a single platform within the Payment Advice interface
- Leverages our eReview system to validate claims, enforce data standards and maintain state reporting compliance
- Yields consolidated and consistent data analytics via the Enterprise Reporting module
- Supports data sampling and auditing of vendor pricing and results
This enhancement strengthens the current software delivery model and meets our software delivery schedule in anticipation of our major software release in the fourth quarter of 2013.
Source: ISG Services