Clarus RCM

Clarus RCM is a revenue cycle management solution designed to streamline financial processes for healthcare organizations. This platform caters to hospitals, medical billing companies, and payers of various sizes. According to the vendor, Clarus RCM offers a range of features and functionalities that are utilized by healthcare providers, medical billing professionals, revenue cycle management professionals, healthcare payers, and hospital administrators.

Key Features

Eligibility and Benefits Verification, and Prior Authorization: According to the vendor, Clarus RCM provides services for verifying patient eligibility and benefits to ensure accurate and up-to-date information about insurance coverage. The system also assists with obtaining prior authorization for specific medical procedures or treatments, simplifying the approval process and reducing administrative burden.

Patient Scheduling: Clarus RCM offers functionality for efficient management of appointment bookings in healthcare organizations. The system allows for easy scheduling, rescheduling, and cancellation of appointments, aiming to optimize patient flow, reduce wait times, and enhance patient satisfaction.

Patient Registration: Clarus RCM simplifies the patient registration process by capturing and storing essential information such as demographics, insurance details, and medical history. According to the vendor, the system streamlines registration, eliminating manual paperwork and reducing errors, thereby improving data accuracy and operational efficiency.

Medical Coding: According to the vendor, Clarus RCM provides accurate and compliant medical coding services performed by certified coders with expertise in outpatient, inpatient, and emergency department coding. The system aims to optimize reimbursement, minimize coding-related denials, and ensure compliance with coding guidelines and regulations.

Claim Submission & Rejection Management: Clarus RCM supports timely and accurate submission of claims to insurance providers, aiming to facilitate prompt reimbursement and reduce revenue leakage. The system also manages claim rejections, identifying and resolving issues to minimize denials, improve cash flow, and maximize revenue.

Payment Posting: Clarus RCM offers services for accurately recording and reconciling payments received from insurance providers and patients. According to the vendor, the system streamlines the payment posting process, reducing errors, improving financial visibility, and enabling efficient revenue reconciliation.

Accounts Receivables Management: According to the vendor, Clarus RCM provides comprehensive management of accounts receivables, including follow-up on unpaid claims, denial management, and appeals. The system aims to help healthcare organizations optimize revenue by efficiently managing outstanding accounts receivables, reducing aging of receivables, and improving cash flow.

Denial Management: Clarus RCM assists with denial management, aiming to identify and resolve claim denials to ensure maximum reimbursement. According to the vendor, the system streamlines the denial management process, improving revenue recovery, reducing the number of denied claims, and enhancing revenue cycle performance.

Credit Balance and Refunds Processing: Clarus RCM handles processing of credit balances and refunds, aiming to ensure accurate management of overpayments and timely refunds to patients or insurance providers. The system automates the workflow, reducing manual effort, improving accuracy, and enhancing financial transparency.

Revenue Cycle Analytics: Clarus RCM offers revenue cycle analytics to provide insights into key performance indicators and financial metrics. According to the vendor, the system generates reports and dashboards, enabling healthcare organizations to monitor and optimize their revenue cycle performance, identify trends, and make data-driven decisions for revenue enhancement.