Physician Groups Claims Management Software Solutions

Physician Groups

Physician Groups & Specialty Practices Claims Management

Facilitate rapid reimbursement through workflow automation, denial prevention tools and data-driven claims management to collect more earned revenue.

99.7% first-pass acceptance with payers

The Industry-Leading Healthcare Claims Management Software

The Quadax claims management platform 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 exploited for greater efficiencies and maximum reimbursement. A talented team of RCM experts continually monitors evolving standards and payer rules so Quadax Claims Management is always processing claims based on the latest rules and guidance.

Xpeditor

Automate Claims Management

Xpeditor automates workflow 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 Claims Management 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.

XpressBiller

Auto Fix and Scrub Claims with Custom Rules & Edits

The path to improving clean-claim rates begins with an ounce of prevention. XpressBiller empowers you to automatically detect, assign, correct and minimize errors in real-time before the claim is released to the payer. It does this by preventing the key issues that derail claims and reduce profits. 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.

Edits And Documentation Group (EDG)

Comprehensive Library of Claim Processing Rules and 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 our 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 and 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.

Intelligence by Quadax™

Intelligent Analytics and Reporting

Intelligence by Quadax (iQ) is our all-in-one AI framework built to streamline automation, deliver predictive insights, and optimize performance across the entire revenue cycle. From patient access to denial management, iQ empowers healthcare organizations to minimize friction, accelerate processes, and drive better outcomes.

Additional Features of Claims Management

Convenient FISS Connectivity

Quickly access FISS to make Medicare claims management easier than ever.

The Quadax Portal is your gateway to a wealth of information, valuable resources and customer support, and now, your staff’s gateway to Medicare’s Fiscal Intermediary Standard System (FISS). DDE Link matches Portal files to each of your named users. Users easily log in right from the familiar Quadax Portal using their own Medicare Online System ID and password to access all of the functions they need. Integration with FISS can be quickly and easily enabled with no extra hardware required.

Electronic Claim Attachments

Support electronic claim attachment submission functionality to help free up staff resources, reduce postage costs and secure revenue faster.nn

More and more payers are continuing to advance with technology and lessen reliance on paper, leaving providers to keep up despite the lack of clear guidance on accepted formats or shared common standards. Between varying pre-claim attachment content such as x-rays, operative reports, ABNs, or medical records, your billing system has to support the conversion of both structured and non-structured content. With Quadax you can! Xpeditor™ supports electronic claim attachment submission functionality to free up your staff, save money on resources/postage, and helps you secure revenue even faster.

ICV All-Payer

Proactively prevent claim denials with ICV All-Payer—Quadax’s smart coverage validation catches insurance issues early, giving you clarity and confidence before claims go out.

ICV All-Payer puts proactive, comprehensive validation at the center of your revenue cycle, delivering real-time visibility and control across Medicare, Medicaid (49 states), Blue Cross, Blue Shield, and Commercial payers through one integrated, high-efficiency platform. Learn more.

Advanced Claim Status (ACS)

Advanced Claim Status (ACS) integrates a richer and more complete claim status response into workflow to save staff time and effort and enable further automation.

Advanced Claim Status™ (ACS™) by Quadax is an automated solution giving you actionable claim status information sooner so your staff can work smarter! Using web-bot technology, this direct-to-payer-portal system replaces or supplements standard 276/277 ANSI transactions in order to provide a richer, more actionable data set as soon as one day post-billing.

Supercharge Your EPIC Resolute System

EPIC Claims Processing

Supercharge your EPIC Resolute System with real-time error resolution and streamlined processes. nnSeamlessly 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.

Claims And 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.