Walgreens Health announced Wednesday that it is contracting with electronic data interchange clearinghouse Claim.MD to improve the claims process, reduce denials and improve cash flow.
Based in Pecos, Texas Claim.MD helps providers, software providers and insurance carriers manage electronic medical transactions. The company was founded in the early 1980s and has an insurance network that includes Medicare, Medicaid and commercial payers. Walgreens Health, a business unit of the retailer, aims to provide equitable, personalized health care for the whole person to local communities across America in a way that is convenient for consumers – in the store, at home, in the doctor’s office and through a mobile application .
“Essentially, Claim.MD connects providers with insurance companies and other payers, offering tools and clearinghouse services that help healthcare providers improve their bottom line,” said Nihal Titan, Vice President of Claim.MD. “They create a single point of communication between all the different claims processing systems to simplify the physician payment process.”
Claim.MD converts patient claims information from Walgreens Health to ANSI X12 electronic standards. This allows staff members to review and correct errors in claims and monitor remittance data through an online portal. If Walgreens needs to contact a payer, Claim.MD provides a complete claim history that can be printed.
“When claims are denied, Claim.MD manages the return process, expedites payment and eliminates the confusion of re-billing,” Titan said.
To further simplify operations, Claim.MD’s software integrates with Walgreen Health’s existing electronic health record and revenue cycle management solutions, Titan added.
Other clearing companies include Changing healthcare, Ability, Availability and Waystar. Walgreens Health did not respond to a question about which companies it evaluated before selecting Clear.MD, but what impressed Brett Kleebauer, director of revenue cycle management at Walgreens Health, about the latter was its performance.
“Inefficiencies within the revenue cycle have become a chronic condition in healthcare, but Walgreens Health is committed to proactively improving our claims operations,” he said in news release. “We turned to Claim.MD to ensure our claims processes were as streamlined as possible and their team delivered an impactful, cost-effective solution. The platform helps us always submit clean claims, which lowers our denial rate while reducing days in A/R to improve our cash flow.”
So far, working with Claim.MD has paid off, Kleebauer added.
“One area of our business that is so important to us is the continuous improvement of the relationship with our paying customers,” he said. “Because the Claim.MD platform provides more timely and accurate billing, it allows us to streamline these interactions. We’ve also been able to grow our business by onboarding new customers because the platform allows us to test claims data from individual payers while easily communicating those findings.”
Photo: sorbetto, Getty Images