Complete Claims

Complete Claims is a solution offered by Complete Health Systems, A MedVision, Inc. Company, designed to streamline and automate the claims process in the healthcare industry. This product caters to healthcare organizations of various sizes, including independent hospitals, consolidated hospital markets, and other healthcare providers. It is utilized by professions and industries such as healthcare providers, insurance companies, hospitals, medical clinics, healthcare systems, health plan benefit administrators, third party administrators (TPAs), health insurance companies, Taft-Hartley Plans, and association plans.

Key Features

Automated Claims Processing: According to the vendor, Complete Claims offers automated claims processing capabilities, reducing the need for manual data entry and streamlining the claims submission process. The system captures and validates claim data, automates the adjudication process, and aims to improve efficiency for healthcare providers.

Real-time Claim Status Tracking: The vendor claims that Complete Claims allows healthcare providers and insurance companies to easily track the status of claims in real-time. This is intended to eliminate the need for manual follow-ups and phone calls, enabling proactive management of claims and potentially reducing reimbursement delays.

Claims Validation and Error Correction: The system includes comprehensive claims validation capabilities, which the vendor says ensure that submitted claims meet all necessary requirements and comply with industry standards. It automatically checks for errors, inconsistencies, and missing information in claims, aiming to improve the accuracy and efficiency of the claims process.

Integration with Electronic Health Records (EHRs): According to the vendor, Complete Claims seamlessly integrates with electronic health record (EHR) systems, enabling the automatic transfer of patient and claim data between systems. This integration is intended to eliminate manual data entry, reduce duplication of effort, and enhance data accuracy for healthcare providers.

Claims Analytics and Reporting: Complete Claims offers claims analytics and reporting capabilities, allowing users to gain insights into claim patterns, trends, and performance metrics. The vendor states that users can generate customizable reports and dashboards to track key performance indicators (KPIs) and make data-driven decisions for optimization.

Efficient Reimbursement Cycle: The vendor claims that by automating the claims process, Complete Claims aims to accelerate the reimbursement cycle for healthcare providers. It is said to reduce administrative burden, improve accuracy, and ensure faster claim approvals or denials based on predefined rules and criteria.

Enhanced Accuracy and Compliance: According to the vendor, Complete Claims helps healthcare providers and insurance companies ensure accuracy and compliance in the claims process. The system automatically captures and validates claim data, aiming to reduce the risk of errors and improve overall data quality.

Streamlined Communication: Complete Claims is said to facilitate streamlined communication between healthcare providers and insurance companies. Real-time claim status updates and automated processes are intended to eliminate the need for manual follow-ups and enhance collaboration, potentially leading to faster resolution of claims.

Improved Efficiency and Productivity: According to the vendor, Complete Claims aims to improve overall efficiency and productivity for healthcare organizations. By automating claims processing, providing real-time tracking, and offering comprehensive validation capabilities, it is said to reduce manual work, eliminate redundant tasks, and enable staff to focus on more value-added activities.