MenuClose

Four Key Considerations when Choosing a Claim Status Partner

Attachment Large Size Large Wp Post Image

In our recent blog about the urgency of claim status inefficiency, we pointed out a few questions to ask when seeking a new or replacement automation vendor. Let’s take a closer look at each of these.

how frequently will my claims be statused?

If it’s not as frequently as necessary for your payer mix, you could be adding days to resolution. Typically, solutions status on either customer-defined or pre-defined schedules.

While customer-defined may sound great, it takes considerable EHR resources to analyze the ideal schedule by payer, set up the timing and routing logic by payer, perform testing, and monitor for ongoing optimization. So much for saving time with automation.

Frequent, pre-defined scheduled status checks are efficient and less burden on the customer, but how your vendor charges for those checks could erode your ROI — more on that below in “How do you charge.”

Case in point

We status your claims a lot. Our Enriched Claim Status customers automate tens or hundreds of thousands of claim statuses each month, saving thousands of staff hours without haggling over transaction fees.

what information will I receive?

Automated claim status solutions vary widely in how much information they retrieve and return to the EHR. New customers are consistently surprised by the quality and quantity of status detail they receive when they switch to Janus Health.

Case in point

Staff at one pioneering academic health system was ecstatic with the level of detail, accuracy, and clarity they received after implementing Enriched Claim Status:

“The information is so much easier; it gives more information than what we were getting with [our previous vendor]. With them, answers weren’t always clear.”

“There’s more information available with Janus Health than there was with [our previous vendor] in the claim status and note – they exceeded that expectation of the granularity they promised for the team.”

what are the success rates of your automations?

Payer portals change constantly, so it’s critical to choose a partner dedicated to maintaining their automation solutions and their relationships with payer aggregators. If a vendor boasts sky-high average success rates, remember the proof is in the outcomes — especially for your unique payer mix.

Case in point

A large Texas health system continued claim statusing with their incumbent vendor while also using Janus Health Enriched Claim Status. Their rationale to commit to switch to Janus Health was clear:

  • We support 88% of their total claim volume.
  • Our automations are consistently successful >80%.
  • We deliver accurate, detailed responses.

how do you charge for your claim status?

Don’t let the return on your claim status investment be diminished by burdensome transaction fees or nickel-and-diming on invoices. Partnering with Janus Health enables customers to maximize their automation budgets without sacrificing quality and volume.

Case in point

What could your organization accomplish with 12% greater account capacity, 5 more hours of daily billing team capacity, or more empowered staff?

We’d love to help you find out. Get in touch today.

Kelly Stover

Chief People Officer, Janus Health

Kelly Stover is an internationally accomplished, results-driven human capital executive, who brings more than 23 years’ experience in defining and implementing talent and recruiting strategies to Janus Health.  
Kelly has personally defined and implemented capabilities that address the full employee lifecycle from hire-to-retire through building and leading high performing HR teams to meet business objectives. During her career, Kelly has successfully led strategic multi-site organizational change in various business settings, managed labor relations effectively, coordinated mergers of culturally distinct organizations, and personally led complex integration projects. Her experience includesroles at organizations including Frito-Lay, Nestle Waters, Keurig Dr. Pepper, Amazon Global Logistics, Boeing Defense and more. 
Kelly earned her BA in Professional Writing at Saint Mary’s of Notre Dame. She is a proud mother of five children and volunteers her time outside of work to support youth sports, career development of others, and youth faith development at her Church. 
Schedule a Demo