For a case management agency, a rejected claim isn't paperwork. It's revenue that arrives late, or not at all.
Where claims go wrong
Most claim problems start long before billing. A note is missing a required detail. A service is billed that the note doesn't support. Information gets re-typed from one system into another, and a number changes on the way. When case managers document in one place and billing staff work in another, every hand-off is a chance for a claim to come back.
Better Life set out to remove the hand-offs.
One record, from the visit to the payment
At Better Life, a case manager's note and the claim it supports are the same record in One Care Portal. Here's the path:
01The case manager documents the contact in OCP Case Management.
02The billable service becomes a claim in OCP from that same note, with no re-keying.
03The claim goes to the payer through OCP's clearinghouse connection.
04The payment comes back: 835 payment files post into OCP, so the team sees what was paid.
The result
Better Life went live within two weeks. Its case managers and its billing run on the same system.
Catching problems before the claim
Clean claims start with clean notes. Compliance Review can flag notes against agency-configured criteria and possible copied or duplicate notes for human review before billing.
What happens to your claims after the note is written?
See the full path from contact note to payment in a 30-minute demo.
