The digital submission of claims, records, payments, and correspondence to multiple payers through a single portal with one login improves the flow of information, removing friction and streamlining all processes. Patient Financial Services personnel can gain significant productivity by using one portal to submit claims to multiple payers.

Our system applies business rules to produce clean claims, both prior to submission and during pre-adjudication. This helps prevent denials and resubmissions, reduce print, mail, and call volumes, and increase auto-adjudication rates so that we ultimately increase member and provider satisfaction.

Iterative feedback loop technology allows the system to continuously learn and improve. Predictive analytics identify errors in claims to enable proactive claims management and system flexibility as your contracts change. As payer rules change, these exceptions are also identified for all PCH Claims Manager users.

PCH automatically identifies “Certain to Deny” claims, increasing first-pass billing accuracy rates by an average of 24-31%, which directly reduces the volume of denials and manual claims processing and improves DSO. Our edit engines validate all SNIP edits and clinical edits based on general payer guidelines for commercial, Medicare and Medicaid processing.

By integrating with Exela’s Medical Lockbox solution, PCH Global centralizes the processing of payments received across multiple channels, including lockbox check payments, ACH payments, and virtual card payments. This provides complete visibility for all payment types along with associated EOB digitization (conversion to 835) services.

The system automatically tracks and records any addition, deletion, or modification of transactions, along with user references and timestamps for all entries in the system, providing clear audit trails and ensuring full compliance. Digitized paper claims become visible to providers to limit processing and communication challenges.