INDIANAPOLIS – RealMed is applying the old adage “Time is money” to the medical claims clearinghouse business.
The Indianapolis-based company is marketing its automated claims and eligibility processing tools as the gateway to a more efficient relationship between healthcare providers and payers. And according to Phil Christianson, RealMed’s chief executive officer, that could save physicians thousands of dollars in billable opportunities that they’d otherwise waste in arguing with health plans over the phone.
“As they use our application, it changes the workflow in the office,” he said. “We reduce the number of calls they have to make and we change the way they work so they can focus on the exceptions.”
RealMed provides the platform upon which patient eligibility and payment can be aggregated, allowing providers to process claims with multiple payers. Christianson said that platform allows providers to process the bulk of average claims properly.
Christianson says real-time eligibility verification helps payers as well as providers. Payers want to pay a bill promptly and properly, he said, while providers want to improve the billing process and focus instead of the delivery of healthcare.
“What these tools do is make the providers more efficient,” he said.
RealMed has clients in several states and is looking to grow. The company recently signed contracts with the Adventist Health System, an Orlando-based healthcare provider with hospitals in several states; and TSI healthcare, a Chapel Hill, N.C.-based network of nearly 1,000 physicians.
“We chose RealMed because its subscription covers many of our practices’ key revenue management services at a reasonable monthly price,” said Tim Reiner, Adventist’s senior revenue officer. “They have a true software as a service model. RealMed’s functionality sets it apart, having interactive pre-submission claim eligibility, EDI claim tracking through multiple dispositions in the payers’ adjudication cycle, and the unique payer integration with key national and regional payers in our market.”
“RealMed is head and shoulders above their competing clearinghouses because they integrate with our Electronic Practice Management system for batch eligibility, automated claim file transmission, and automatic interface of claim changes,” he added. “Through our partnership with RealMed, we expect to lower our days in AR and avoid costly delays and denials.”
