What if four to ten percent of your business’s invoices went unpaid? That’s what’s happening to physician groups who don’t have the ability to keep close track of claims.
When managing administrative costs and physician reimbursement, making sure group practices obtain accurate claim payments and recover underpayments efficiently is critical. On average, four to ten percent of claims are incorrectly paid, according to industry experts.
But Trizetto and NHXS, a Sacramento, Calif.-based company that offers provider claims reimbursement management tools, is out to fix that, with NHXS’ software that helps medical practices manage physician reimbursement and minimize the administrative cost of recovering lost revenues, according to a company press release.
Under the organizational framework of its wholly-owned subsidiary, Gateway EDI, NHXS will become part of the Trizetto “family.”
NHXS’ software and capabilities will be integrated with Gateway EDI’s solutions, which include EDI and revenue cycle management services for more than 100,000 physicians.
Revenue cycle management. Fancy words, but they simply mean making sure you get paid. By some estimates, hospitals lose three to five percent of their net revenue from inadequate revenue cycle management, according to Elizabeth Stuller. For the average 300-bed hospital, this could mean revenue losses of $4.5 million to $9 million each year – often the difference between breaking even and operating in the red. Think what it means for your practice.
But by allowing physicians’ offices to identify and reduce inaccurate payments, TriZetto sets out to help the industry improve clinical communications, as well as the cost and quality of care delivery through an integrated, real-time provider-payer technology platform.
“NHXS’s solution suite augments our current solutions for medical offices,” said Trace Devanny, chairman and CEO at TriZetto. “Its offerings help group practices obtain accurate claim payments, recover underpayments and free up more time to provide medical care for patients. NHXS’s offerings benefit healthcare payers, as well, by reducing the number of appeals and administrative expenses associated with claim corrections and reprocessing. The addition of NHXS is one more step by TriZetto toward an integrated, real-time provider-payer technology platform that helps physicians and health plans achieve higher levels of efficiency and productivity and lays the foundation for improved clinical communications.”
According to the souce, NHXS has worked with Gateway EDI since 2009, when the organizations jointly developed the Reimbursement Manager tool, making it easier for providers to identify payment inaccuracies.
NHXS’s current leadership team will continue to run the organization’s day-to-day operations.
Edited by
Braden Becker
