Name: ClickON Claims Processing Tools
Author: The SSI Group

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ClickON Claims Processing Tools, developed by SSI Group, is a claims management solution designed to streamline billing practices and enhance reimbursement efforts. According to the vendor, this software guides users through the electronic claim submission and reconciliation process, aiming to ensure accuracy and efficiency. ClickON Claims Processing Tools caters to a wide range of industries, including hospitals, physician offices, rural health clinics, long-term care facilities, and long-term acute care centers. It is said to offer a robust set of features to meet the unique needs of each profession and industry.

## Key Features

**Claims Management Workflow**: According to the vendor, users can monitor the entire claims processing lifecycle, create smart queries and workflow queues, and work claims based on user-defined priority levels. The software is said to provide error prompts and help messages to expedite claim correction, and it integrates with major patient accounting systems.

**Billing Edits**: The vendor claims that this software helps decrease denials by offering clean claim and first-time payer acceptance rates. It provides access to HIPAA and ANSI standard edits and allows users to request and implement custom edits. Additionally, it offers the flexibility to bypass warning edits.

**Clearinghouse**: According to the vendor, ClickON Claims Processing Tools automates the exchange of information between the system and patient accounting software. It is said to streamline electronic and paper claim processing, maximize first-time claim acceptance with a second layer of editing, and optimize staff productivity by minimizing manual work and follow-up. The software also aims to simplify claim payment collection from payers.

**Flexible Claim Status**: The vendor states that this software helps users identify denials before receiving the remittance advice, rebill correctable claims, and start the appeals process sooner when necessary. It aims to decrease payment turnaround time by responding to requests for additional information promptly. The software also offers payer-specific settings to increase staff productivity.

**Electronic Attachments**: According to the vendor, ClickON Claims Processing Tools allows users to attach and submit relevant documents to claims more efficiently, reducing payment delays and denials. It is said to alleviate administrative burdens and enable a virtual workforce. The software aims to save costs on printing, mailing, appeals, and mailroom operations, while improving cash flow and accuracy of documentation.

**Remittance Management**: The vendor claims that this software eases billing to payers subsequent to the primary payer on a claim. Users can access, view, and print Explanation of Benefits (EOB) through the system. ClickON Claims Processing Tools aims to establish a single source for all electronic payer remittances and offers features to post files to host and/or accounts receivable systems. It also provides system-initiated denial follow-up to guide staff activities.

**Denial Management**: According to the vendor, this software allows users to categorize and establish root cause assignment on denials. It aims to develop a streamlined claim and line-level denial workflow, and users can manually link remits to claims not initially matched. Denials can be auto-assigned to users based on denial type, and the software incorporates follow-up and timely appeal filing deadlines into the workflow.

**Bill Date and Confirmation Note Posting**: The vendor states that ClickON Claims Processing Tools seamlessly integrates with the hospital information system. It provides guidance for appropriate follow-up and workflow based on bill job completion and/or confirmation and claim status receipt.

**File Folder**: According to the vendor, this software provides a repository for all pertinent documents created during the claims management lifecycle. Users can access this feature from any claim in the system.

**Correspondence Conversion**: ClickON Claims Processing Tools allows users to convert correspondence into electronic format for efficient storage and retrieval, according to the vendor.

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ClickON Claims Processing Tools

Insurance claims management software focus primarily on providing information essential for the evaluation of claims with a centralized system of record. Beyond providing operational efficiency in the management of claims, insurance claims systems should also reduce the risk of fraudulent claims by providing access to all relevant data associated to claims in an organized fashion, supporting risk evaluation.

Insurance Claims Management

The SSI Group

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ClickON Claims Processing Tools

Overview

What is ClickON Claims Processing Tools?