Change Healthcare Helps Providers Reduce Denials Before They Start

Jun 25, 2018, 8:00 AM
Transparency2

Las Vegas, June 25, 2018, HFMA Annual Conference—Change Healthcare today unveiled a new technology that helps providers reduce one of the leading causes of claim denials. Assurance Attach Assist™, a module of Change Healthcare Assurance Reimbursement Management™, now anticipates what documentation a payer—including Medi-Cal and seven other payers—may require to help prevent the denial of a claim due to lack of documentation. The result: Providers can now use Assurance Attach Assist's automation as a tool to proactively decrease documentation-related denials, and improve efficiency of the claims and payment workflow, which may result in accelerated cash flow.

Once sophisticated edits proactively identify claims that need additional documentation, Assurance Attach Assist provides users with the capability to electronically submit the necessary attachments both during and after claim submission. The documentation can then be tracked within Assurance Reimbursement Management to maintain full visibility until the claim reaches its final resolution.

Over two million requests for medical documentation—i.e., attachments—are issued annually by payers for claims processing.1 Providers spend about $5.25 and 30 minutes per claim manually dealing with these requests.2 Approximately 10% of claims are denied each year due to missing documentation.3 All these scenarios can result in claim denials and lost revenue. Now, by using Assurance Attach Assist, the risk of denials based on lack of attachments can be mitigated.

"The key to reducing denials is to address requirements on the front end before they become problems on the back end," said Marcy Tatsch, senior vice president and general manager of Reimbursement and Analytics Solutions at Change Healthcare. "There are so many factors that can trigger a denial. Providers need proactive technology that helps them anticipate and eliminate issues before they cause a denial. We continue to invest in the tools that help our customers reduce the administrative burden and speed revenue cycle velocity."

Assurance Attach Assist provides the ability to electronically submit supporting documentation—both solicited and unsolicited—to a growing selection of commercial and Medicare payers. Attach Assist supports Medicare (solicited attachments only), Medi-Cal, Blue Cross California Medi-Cal, Anthem Blue Cross–California, Anthem Blue Cross Blue Shield–Nevada, Anthem Blue Cross Blue Shield–Colorado, PacificSource Health Plans, and Washington Medicaid (solicited attachments only).

The addition of Medi-Cal, California's Medi-Cal program, is crucial to providers. Medi-Cal covers over 13.3 million members through six managed care and fee-for-service models and is particularly complex for providers to navigate. In fact, "Medical Documentation Requested" remains one of the top five reasons for Medi-Cal claim denials.4

Assurance Attach Assist is available now for users of Change Healthcare Assurance Reimbursement Management. Change Healthcare will demonstrate the new technology in booth 402 at HFMA Annual Conference, June 24-27, 2018, in the Venetian-Palazzo Sands Expo, in Las Vegas. A complete summary of Change Healthcare activities at the HFMA 2018 Annual Conference details the company's activities, speakers, and demonstrations.

  1. CMS Office of Financial Management, Introducing Electronic Submission of Medical Documentation to Clearinghouses, 2015.
  2. CAQH Index, 2016 Identification functionality only available with Assurance Medicare Direct Entry module
  3. Based on Change Healthcare de-identified claim and remit data using primarily institutional inpatient and outpatient claims, 2017
  4. Ibid.
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