Credentialing AI by Billing Paradise automates payer contract management and payment recovery. It integrates with healthcare systems to streamline contract negotiation and identify underpayments. Features include payer benchmarking, underpayment detection, and contract management insights, helping optimize reimbursement processes.
Features
Payer Benchmarking
Allows comparison of current payer contracts with market rate compensation, providing insights into payer relationship health.
Credentialed Contract Management
Streamlines the management of payer contracts by organizing and automating documentation, ensuring compliance and facilitating faster revenue recovery.
Benchmarking Overview Dashboard
Provides a visual representation of benchmarking analysis, allowing users to easily track payer compensation against national average rates.
Automated Underpayment Detection
Identifies and highlights undetected underpayments from payers, reducing revenue loss due to manual errors.
Role-Based Workflows
Enables specific roles within an organization to manage contract negotiations and credentialling processes efficiently.
Data Reporting and Export
Provides reports and data exports with detailed insights into payer maps and contract performance.
Denial Pattern Identification
Automatically identifies patterns in claim denials to assist in determining root causes and implementing corrective actions.
Workflow Automation
Automates the denial management workflow, reducing manual effort and streamlining the revenue cycle process.
Integration with RPA Platforms
Leverages integration with platforms like Olive, UiPath, and Blueprism to enhance automation capabilities.
Data Security and Compliance
Ensures data security through SOC 2 Type 2 and ISO certifications, providing reliable protection and compliance.
Revenue Recovery
Focuses on maximizing revenue recovery by addressing 85% of the denial scenarios and providing actionable insights for resolution.
Appeal Automation
This feature automates the appeal process for denials, reducing manual effort and speeding up the recovery process. It uses customizable templates for quick resubmission.
Audit Control
Provides tools to manage and control audit processes efficiently, ensuring compliant and streamlined auditing.
Real-time Denial Management Analytics
Offers real-time analytics and insights into denial patterns, helping healthcare providers quickly identify issues and improve their processes.
RPA Denial Management Technology
Utilizes Robotic Process Automation to streamline denial management, reducing errors and increasing efficiency.
SDK and Denial Management Toolkit
A software development kit and toolkit designed to integrate with existing systems for enhanced denial management capabilities.
Denial Software
DenialManager is a software that integrates denial management systems with EHR, analyzing claims to provide comprehensive management solutions. It helps identify, isolate, quantify, and categorize denials to lower claim denial rates and prevent revenue leakage.
Compliance
The company is SSAE16 SOC2 compliant and follows HIPAA audits. Offices are spread across 6 locations globally, supporting service delivery on a flexible and agreed timeline, ensuring compliance with relevant standards.
TeamBillingBridge
This tool offers a dashboard to manage revenue cycle activities without detailed spreadsheets. It provides financial metrics and navigational ease, allowing broader oversight of billing activities.
Workforce Management
A system designed to automate and streamline denial management by sending daily reports. It reduces dependency on manual processing, boosts productivity, and assigns tasks efficiently.