Sycros Healthcare IT - EHR Services

Billing Services

Sycros Partners with alloFactor and DigiDMS to provide billing services. The Practice Management module, which is the billing solution, is geared towards billing staff to most productively manage insurance claims and billing life cycle. Once a visit is completed, the claim automatically flows into the claims module. If the patient diagnosis and charge codes were entered during sign-out, creating the claim with a single click. Claims can be instantly filed or batched for electronic or paper filing. Payment can be instantly posted through ERA and paper EOBs can be manually posted. Super-bills and EOBs can be scanned and stored electronically. All communication relating to a claim is structured for easy retrieval. Claims can be printed using customized provider or payer or printer specific templates

Never miss billing Encounters

As soon as the front-desk checks in a patient, the visit immediately appears in the Claims module as a visit to be billed. Tracking visits in this fashion ensures that not a single claim goes unbilled.

Rapid Claim creation

Once you have received the diagnosis and charges from the frontdesk, creating the claim is a snap. Typically if you have setup defaults, you can create the claim at the click of a button. If you are new to billing of if you need to override the defaults to gain specific control over individual fields, you can use the claim creation wizard.

Tracking Claims

Typically medical billers work on a group of claims with a certain status such claim denied or primary paid. Each visit can be tracked through its life with the various statuses, thus tuned to the way your staff works. The status is automatically managed by our billing service. Your billing staff can also manually change the status of a claim or a group of claims at any time.

Easy charge capture

Diagnosis and charges can be easily captured and transmitted to the biller in various forms. They can be entered directly into the system by the front-desk by the physician through EMR module. Or it can be marked on the encounter form by the physician and scanned into our Practice Management. Or it can be entered in mobile device and synched using our Practice Management. Use explosion codes to quickly enter a commonly used set of charges along with their fees, modifiers, POS and TOS.

Scanning superbills & EOBs

With our Practice Management, you can easily scan in superbills and EOBs and use the system as a document management system. Quickly review which documents need to be processed. After working on a superbill or EOB billing staff can mark them as processed.

Setup billing defaults

You can easily setup billing defaults such as default group, NPI numbers, tax ids, facilities to reduce the time you spend on each claim. In fact if you set them up, creating a claim is as simple as enter the diagnosis and charge for a claim.

Submit claims electronically

After creating a claim in the Practice Management submit it instantly to over 2000 payers at the click of a button. No longer do you need to create print images and go to separate websites to submit them. Now do you have to deal with different clearinghouses to submit your claims - we take care of all enrollments for you. You will get instant response on whether the claim passed the built-in edits in the Practice Management. Once submitted you will continue to see detailed status of the transmission to the payer. See more details on electronic claim submission here

Print Paper Claims

Alternatively when you do need to send in paper claims, you can print CMS1500 claims and mail them out. Default formats are included in the system; but you can modify them to adjust for printer specific spacing or create separate formats with default texts for different payers. You can create primary and secondary claims formats specifically for corrected claims.

Claim Status

Once a claim is submitted electronically, the Practice Management posts detailed status as it makes its way to the payer. First the Practice Management checks the claim against its own internal claim edit database and immediately rejects any claim that fails the edits. Once rejected the status of the claim will immediately change to 'Claim Rejected' along with the reason for the rejection is given so that you can easily rectify the issue and resubmit the claim immediately. Next as it makes its way through the clearinghouse, the claim goes through additional edits and any rejections are posted to the claim. Finally the claim is passed to the payer and any rejection from the payer is made available to you.

Electronic Remittance Advice (ERA)

One of the most productive yet least used EDI transactions is electronic remittance advice. With ERA, you receive the same information as in paper EOB in electronic format. One of the advantages is that you get an ERA instantly while paper EOB can take days to reach you. But more importantly, ERA eliminates the hours that your biller puts into posting payments against each claim. With our ERA, the payments are automatically posted and any that cannot be posted automatically is marked for manual posting. You can also view your ERA documents in Adobe Acrobat(tm) format and save them or print them directly from the Practice Management. See more details here.

Working claim rejections and denials

If a claim is rejected by clearinghouse or payer, its status is automatically changed to Claim Rejected. If you are using ERA, any claim denied by your payer is automatically changed to Claim Denied status. Your billing staff can pick up only rejected or denied claims and work on them, using the detailed information on the cause of the rejection/denial.

Checking claims for errors

If you are solely relying on manual error checking it will cost you time and money! Our built in business rules engine scrubs your claim against our internal rules database to prevent claim rejections and denials. Check each claim for error at the time of creation or during electronic submission.

Additional service

Medical Transcription
Representative Follow-up

DigiDMS

ClinicSpectrum

AlloFactor