Parathon simplifies the revenue cycle process for Providers, by offering a wide variety of powerful Transaction Services tools – all accessible in the same dependable interface you’ve come to trust for your other revenue cycle needs. We understand that adding a variety of bolt-ons made by different vendors means having to deal with multiple interfaces, wasting valuable time and resources. So we built a comprehensive suite of Transaction Services, enabling you to access any tool in your revenue cycle arsenal in one trusted and familiar one platform. Learn more about each of our tools below.
- Parathon® Claims Clearing (ParaClaim®)– This service provides centralized management of the claims delivery process. Providing for integrated editing of claims, including site specific edits and customizations. ParaClaim® Includes integrated Medicare editing capability including medical necessity and correct coding initiative edits. It also provides seamless delivery of claims for all electronic payers including automated tracking purposes.
- Eligibility Services – This service provides automated real time verification of critical patient insurance eligibility information, such as name, SSN, plan, and policy number. This service automatically compares the data to all major payers, like Medicare, Medicaid, Blue Cross/Anthem, Aetna, Cigna, etc. to check for “coverage” other than what is recorded in Customer’s information system. Depending upon Customer’s policies and procedures co-pay, coinsurance and deductible information acquired from some payers can be used at pre-registration or registration to request payment, or make arrangements for patients to satisfy their financial responsibilities at these times.
- Automated Claims Status (ACS) – This service provides daily automated claim status and audit follow-up for all third party payers that support this service.. Such system shall provide application interfacing directly to payer adjudication systems wherever available, including web-based and terminal emulation access. Information collected through the ACS process shall be integrated into Parathon’s® Collector Workstation queues and otherwise available to Customer for ancillary needs. Additionally, the system will provide detailed exception and dashboard reporting as well as process management. The ACS shall provide an integrated audit tool to substantiate timely follow-up activity on all reported accounts.
- Automated Payment Posting – This functionality provides automated and electronic posting of all payer and patient payment transactions. On a daily basis, Parathon will collect all electronic HIPAA compliant 835 electronic files and electronically post such files directly into your legacy information systems within twenty-four (24) hours after Parathon’s receipt of such files. Parathon and Customer will work together to resolve posting of non-HIPAA compliant 835 electronic files received by Parathon. On a daily basis, Parathon will provide Customers with an “exception” report containing a list of all transactions which cannot be posted electronically.
- Parathon CDM Price Sensitivity Analysis – Parathon’s CDM Price Sensitivity Analysis lets you focus your annual CDM price changes on the service charges that have the largest net gains and allows you to lower the prices on service charges that do not affect your bottom line. The software performs an analysis of CDM and fee schedule liquidation on claim parameters defined by the customer. It identifies the service code charges that have the largest impact on expected reimbursement, in both positive and negative variations. The data and calculations are based on the Contracts (loaded and maintained by Parathon and the customer) and the CDMs and fee schedules as well as the claims in the Parallel Databases.