Supported Systems | Payer List

About the speakers

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COVID-19 & REVENUE CYCLE WEBINAR SERIES

COVID-19: Electronic claim processing with Waystar & NGS

Review the presentation from a recent virtual roundtable with representation from Waystar, Jopari and NGS, one of the largest Medicare contractors for CMS. Our Waystar speaker provided an overview of the COVID-19-related CMS changes and answered your most asked questions. These slides will provide you with insight into what changes and what remains the same for your healthcare organization’s revenue cycle.

This presentation will review:

Expansion of Medicare covered telemedicine services
Emergency waivers and additional CMS updates
Waystar and NGS claim processing FAQs
Leveraging electronic claim attachments to expedite processing timelines

View presentation

SPEAKERS:

Renee Miller, Director, Product-Claim Management Solutions, Waystar

May Lynn Bushman, EDI Consultant, NGS (CMS)

Sherry Wilson, Chief Compliance Officer, Jopari Solutions

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Waystar Claims Monitoring ebook
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Waystar Claims Monitoring data sheet
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Waystar Claims Monitoring case study
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Waystar Claims Monitoring webinar
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Feature

Waystar

Other

Details

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Waytstar

Category
Average

Overall Score

95.7

87.3

% Clients Satisfied

73

N/A

Best Vendor Relationship

95.2

84.3

Product

94.2

86

Value

96.9

86.6

Operations

95.5

88.9

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90%

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90%

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CLAIM MANAGEMENT

Most popular

Starter

Simplify Denials Management

Core

Reach Workflow Excellence

Performance

Get visibility into the claim lifecycle

Premium

Achieve Revenue Cycle Automation

	Expanded claim lifecycle visibility through date tracking and proof of timely filing reports
Automated front-end claim editing and scrubbing		●	●	●	●
View and edit claims in customizable workgroups for prioritization and staff assignment		●	●	●	●
Payer response clarified and simplified with Simple Response™ technology		●	●	●	●
Hundreds of crowdsourced rules and edits		●	●	●	●
Claim process lifecycle visibility with date tracking and proof of timely filing reporting		●	●	●	●
Dashboards and reports for key rev cycle performance and user productivity metrics		●	●	●	●
Real-time claim status inquiries with approximately 5-7 second payer responses		●	●	●	●

	Make eligibility and benefit coverage inquiries
Leverage 1,200 payer connections		●	●	●	●
Verify eligibility and co-payments		●	●	●	●
Quickly and easily enter patient info		●	●	●	●
Expedite check-in by accessing real-time plan information in seconds		●	●	●	●
Automated provider enrollment		●	●	●	●
Denial prevention with automated pre-claim eligibility verification		●	●	●	●

	Streamline denial management
Flexible workgroups and automation to close non-workable denials		●	●	●	●
Eligibility integration to check patient coverage within denial workflow		●	●	●	●
Root cause reporting to reduce preventable denials		●	●	●	●
Robust outcome reporting and dashboards for user-friendly resubmissions and payer follow-up		●	●	●	●

	Simplify appeal processes
Appeals wizard that allows you to create three-step, 100% paperless appeals packages		●	●	●	●
More than 600 payer appeal templates available and pre-populated with remit and provider data, including proof of timely filling		●	●	●	●
Custom and dynamic attachments and saved responses streamline submission		●	●	●	●
Ability to batch 100 similar appeals to same payer		●	●	●	●

	Automate claim status checks
Custom schedules to accommodate follow-up workflow			●	●	●
Proactive claim status checks based on predictive analytics that determine optimal timing			●	●	●
Automatic claim status checks without the need for batch files			●	●	●
Early notification of pended claims			●	●	●
Payer response clarified and simplified with Simple Response™ technology			●	●	●
Ability to work by exception with focused workgroups			●	●	●

	Visualize your performance and deliver actionable insights
Custom dashboards and reports				●	●
Alerts to drive corrective action when KPIs deviate from target range				●	●
All-in-one, standardized rev cycle analytics for financial performance clarity				●	●
Intuitive drill-down capabilities to identify key details in the health of the rev cycle				●	●

	Automate bank reconciliation processes
Automated identification of missing or inaccurate deposits and ERAs					●
Streamlined payment posting workflows to avoid posting delays that increase AR days					●
Aggregated reporting for payment information —even if you use more than one bank					●

	Convert paper EOBs to electronic files
Indexing of checks and documents for historical tracking					●
Automated payment posting and reconciliation					●

FEATURES

ANALYTICS PRO

ANALYTICS PEAK

Expanded claim lifecycle visibility through date tracking and proof of timely filing reports PRO + PEAK +	+	+
Dynamic, interactive, easy-to-use data visualization tools that allow for a deeper understanding of your rev cycle PRO + PEAK +	+	+
Your data unified on an end-to-end RCM platform PRO + PEAK +	+	+
Unlimited custom dashboards + reports with simple, yet robust BI tools to see and explore the data your way PRO PEAK +		+
Tailored insights with custom defined calculations, definitions and KPIs unique to your organization PRO PEAK +		+
Ad-hoc data analysis tools for deeper insights into every facet of your revenue cycle PRO PEAK +		+

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Number of claims you follow up on monthly

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Number of FTEs dedicated to payer follow-up

< >

Fully loaded annual salary of medical biller

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Total savings per year

$204,327

These numbers are for demonstration only and account for some assumptions. Contact us for a more comprehensive and customized savings estimate.

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Monthly claim volume

< >

Current denial rate

< >

Average claim value

< >

Average number of appeal packages submitted per month

< >

Total additional revenue recovered per year

$204,327

Total staff hours saved

These numbers are for demonstration only and account for some assumptions. Contact us for a more comprehensive and customized savings estimate.

Gross patient revenue

Net patient revenue

Patient mix (% Inpatient)

< >

Payer Mix (% Commercial)

< >

Payer mix (% Government)

< >

Payer mix (% Other/self pay)

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Note: The above values need add up to 100%

100%

$1.8M

$2.2M

$3.3M

$7.9M

OUTER RANGE: Likely cash impact range for a system of your size

INNER RANGE: Most probable range given your specific information

Benefit range accounts for benefit to be attained through missing charges, CPT coding errors and DRG assignment errors. This calculator is designed to be educational in nature based upon limited information. It is therefore not a guarantee of performance. 1 HFMA blog, 2016

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