Authorization and Referral Management

Obtaining prior authorization for services can place a burden on staff, but this is critical for reimbursement. If prior authorization is not performed, clinicians may find that they have performed unnecessary or duplicative services. Authorizations done correctly help physicians properly diagnose patients in a timely manner. These prior authorization and insurance verification best practices allow you to minimize these time-intensive processes while still ensuring a high quality of care for your patients and a high payment rate from payers. Datamatrix provides a quick and cost-effective process for all your authorization needs. This allows less turnaround time to make appointments. Without authorizations, providers may receive a reduction in reimbursements or no reimbursements at all.

Insurance Eligibility Verification

Verifying insurance eligibility is one of the most important steps in the medical billing process. Patient insurance verification plays a key role in any healthcare specialty’s claims denials. Datamatrix provides a fast efficient, scalable and economical solution for your insurance eligibility verification needs. If benefits are not verified then payment for services rendered by the provider is not guaranteed. Our team is able to manage even your last-minute walk-ins and get benefits verified immediately. Datamatrix’ s specially trained staff is experienced in verifying coverage for all major and minor medical insurance plans. Our team also works extensively with the paper work required for workers comp as well as other insurances. Datamatrix’s team communicates with payers through their authorized online insurance portals or through their insurance call center reps. Information regarding eligibility can be directly entered into our clients EHR system.

Voicemail Messages

DataMatrix can accurately transcribe voicemail messages into your EHR quickly and cost-effectively. With our solution, your employees spend less time retrieving messages and more time on face-to-face patient care. Our solution helps your staff be prepared to speak with patients on a call back after reviewing the original request with a physician. It allows for tracking phone messages being entered into an EHR system directly. It also provides easy reporting of how many actual voicemail messages are received and being answered. Messages can be tasked to doctors and/or staff.

Document Management Services

DataMatrix is able to index your medical records directly into your EHR system. This is an important function for organizing and storing information such as the patient’s demographic and treatment information together in one place for easy retrieval later. DataMatrix’s medical document management truly helps with timely entry into your EHR. Our solution tracks all your documents accurately and we do it all for a fraction of your in-house costs.

Billing Services

We provide man power support for billing processes. The practice manually enters or imports billing information to be accessed remotely by DataMatrix for processing and claim creation. Claims are submitted by practice or by DataMatrix for adjudication. DataMatrix manually enters and/or imports charges from existing system to create claim files and submissions. Payment posting can also be handled by DataMatrix staff. Working with the practice in conjunction with their vendor to understand the medical billing process and file structure to edit/update upfront scrubbing process and the impact on submitting claims.

Coding Audits and Coding Services

DataMatrix can conduct regularly scheduled audits (quarterly) where practice staff provides random samples for review. DataMatrix can provide daily coding for all or selected services. Practice staff would need to provide notes, bills, and any other supporting documentation required to provide an audit. DataMatrix can automatically schedule quarterly audit performance with random selection in conjunction with daily coding. Daily reports are transmitted. Audit results and compliance plan performed and reported, system update recommendations. DataMatrix could also work with your vendor to complete system updates, daily required coding and reporting; additional provider training as required for optimal documentation. DataMatrix can also provide a prepackaged audit solution toolkit for practice to implement with support option for implementation, support and review of specialized coding requirements by vertical.