Best Healthcare Claims Management Solution
Hospitals & Health Systems Claims Management Solutions
Four-time winner of the Best in KLAS award for Claims Management! Achieve an industry leading clean claim rate of 99.7% first-pass acceptance with payers for fast reimbursement.
99.2% first-pass acceptance with payers
Automated & Analytics-Driven Healthcare Claims Management
A four-time KLAS award winner, Quadax’s Claims Management solution achieves a 99.7% first-pass acceptance, and facilitates rapid reimbursement, through workflow automation, denial prevention tools and data-driven claims management to help you collect more earned revenue.
Our Claims Management solution integrates with your internal billing, EHR applications and other sources of data. Automated workflow ensures claims reach billers quickly, while rules-based claim validation maximizes a claim’s likelihood of success prior to submission. Advanced reporting and analytics help you maintain compliance and uncover trends that can be utilized for greater efficiencies and maximum reimbursement.
Quadax’s talented team of RCM experts continually monitors evolving standards and payer rules so you can better utilize staff resources. Rest easy knowing Claims Management is always processing claims based on the latest rules and guidance.
Automate Claims Management Workflows
Quadax’s proprietary claims management software automates workflows to quickly route claims to each biller based on the criteria you define, and when necessary, routes claims internally to maintain an accurate audit trail, reducing the need to communicate through an external environment. Integrated workflow automation between Xpeditor™ and EHRs and/or billing applications result in streamlined processes that improve clean claim rates, reduce administrative costs and provide the insight and control to recover expected reimbursement with speed and efficiency.
Auto Fix and Scrub Claims with Custom Rules & Edits
The path to improving clean claim rates begins with an ounce of prevention. Prevent key issues that derail claims and reduce profits with XpressBiller. Quadax’s powerful rules and edit engine empowers you to automatically detect, assign, correct and minimize errors in real-time before the claim is released to the payer. Now you can gain more control over your revenue cycle and meet the demands of your most difficult payers without involving IT, and at no additional cost.
Intelligence by Quadax™
Revenue Cycle Analytics & Reporting
Intelligence by Quadax™ is a critical reporting and analysis solution that delivers easy access to key performance indicators (KPIs) and other measurements of financial and operational health. Real-time analytics can help your organization make more informed decisions regarding business models and monitor the strength of the organization. Components of Intelligence by Quadax™ include: Decision Intelligence, Predictive Intelligence and Data Intelligence.
Edits & Documentation Group (EDG)
Comprehensive Library of Claim Processing Rules & Edits
Sources and related document links are embedded within Claims Management and offer full transparency into Quadax’s rules and edit logic, policies and procedures. This includes: revision history, payer explanations and links to documentation, recent updates and custom comments–allowing clients to leave their own documentation. Our comprehensive, up-to-date library of claim processing rules and edits are updated bi-weekly by our Edits & Documentation Group (EDG). The Quadax EDG team of experts, who are knowledgeable in both billing and ANSI claim requirements, reference nationally recognized sources, including AMA, CPT guidelines, Medicare Physician Fee and more.
Additional Features of Claims Management
Convenient FISS Connectivity
Quickly access FISS to make Medicare claims management easier than ever.
Integrated Coverage Validation (ICV) for Medicare and Medicaid
Reduce Medicare and Medicaid eligibility and registration denials with electronic access portals to alert billing staff of missing or inconsistent details prior to claim submission.
Real-Time Error Resolution in Epic
Epic Claims Processing
Seamlessly integrate claims generated by the Epic Resolute Billing system with all facets of Xpeditor into a single process, applying industry-leading Xpeditor claims management edits and rules for cleaner claims, while retaining workflow and response data in the Epic Resolute system. No need to wait for the next batch, Quadax returns the claim validation and response almost immediately to help you increase efficiency and accelerate reimbursement.
Before we decided to go with Quadax for claim processing we had several areas in our revenue cycle that needed attention. With the implementation of their workflow and automation tools, Quadax was able to dramatically improve our clean claim rate which allowed us to reduce back-end denials, eliminate re-work and allowed us to reorganize our teams to become a more efficient billing office.”
— Jonathan Hendricks, Corporate Director, Commonwealth Financial Resources (MedCenter Health)
Claims & Reimbursement Support Services
Rely on the Experts
Quadax revenue cycle experts provide routine, on-site visits to assist with event creation and resolution, continued training, reporting needs, best practices and general issue resolution. Quadax provides the perfect blend of sophisticated technology with reliable, expert, personal support.