Decipher Your 835/837 with Our Super-User Friendly UI
ERA and Claim Viewer for Mere Mortals
- Upload hundreds of EDI files in a matter of minutes
- All fields are nicely formatted and logically grouped together
- Intuitive search and filters to quickly find what you need
- Save and search multiple years worth of history
- Support for multiple users
835 and 837 Conversion to Excel/CSV
Convert X12 EDI files to CSV/Excel or JSON
- Ultra-fast parsing and file loading
- Files can be loaded automatically via SFTP
- All codes are enriched “on the fly” with descriptions and other metadata
- Customization of the CSV output
- REST APIs for automated conversions from your application
Claims and ERA Analytics
- Understand your key metrics, including billed and paid amounts and claim volumes
- Analyze your adjustments and rejections
- Group and filter by providers and specialties
- Gain insight into procedures and diagnosis
- Perform temporal analysis, including trends and spikes over time
- Understand your patient demographics and their conditions: group and filter by age, gender, location
Reference Data Set Management
Reference data sets are taken care of, automatically
- All codes are automatically annotated with descriptions and guidelines from authoritative sources
- Reference data sets include ICD, CPT/HCPCS, NDC, Type of Bill, and many others
- Updates are applied as soon as a new version is released; historical codes are preserved
- Procedure codes classification using BETOS/RBCS
- Support for provider taxonomies, adjustment codes, and X12 codes
Billing and Payment Integrity, Data Quality
Catch a wide range of billing and general issues
- Claim scrubbing against Medicare’s National Correct Coding Initiative Edits (NCCI) and Medicare Code Edits (age and gender exclusions, etc.)
- Suspicious billing anomaly and outlier detection
- Identification of duplicate claims
- Support for a manual review workflow with statuses and notes
- Strict validation against X12 EDI specification and reference code sets
