The VistA-Edge RCM is an Integrated Enterprise Cloud based Revenue Cycle Management
The VistA-Edge RCM is an easy to use system with rich features for Patient Registration, Appointments, Paper and Electronic Claims that conforms to 5010 HIPAA messages. All patient registrations and appointments are sent automatically to your EMR. All billing related information including CPT and ICD codes are received back from your EMR for automated billing.
Scalable from Single Physician/Clinic or Hospital to a multi-location healthcare institutions based in multiple time zones.
Ensure that all costs are Captured, Claimed and Collected and no income falls between the cracks – using Dashboards and Extensive Reporting.
Integration with Electronic Health Records.
Suitable for use with any version of VistA (the Electronic Health Record system in use by the Hospitals of the Department of Veterans Affairs).
Can be deployed as a Standalone system or Integrated with any other Electronic Health Record System.
VistA-Edge RCM Features
Patient Registration
Patient Registration along with printing of standard HIPAA forms, Face sheet, Patient Bar-code label generation
Patient ADT
Make patient Admission/ Discharge/ Transfer and send the information to your EHR systems
Insurance Verification & Eligibility checks
Real time Electronic Insurance Verification and Eligibility checks using HIPAA 5010 (270/271) messages while doing the Patient’s schedules.
Scheduling
Advanced Patient/ Resource Appointment Scheduling catering to multiple Time Zones
Appointment Reminders.
Automated email & text message reminders
Internal Scrubber
Internal Scrubber – for various checks before sending the claims to the Insurance Company
Professional & Institutional Claims
Handles Professional (CMS-1500) Outpatient and Institutional (UB-04) Inpatient Claims
Automated Billing
Easy Automated Billing – Paper and Electronic claims (837P/837I/835) conforming to HIPAA 5010 standards
Advance Billing
Secondary & Tertiary billing including Interim Claim feature
Contract Management
Insurance Contract management
Send secure E-claims
Send Electronic claims directly to multiple clearinghouse (Emdeon, Availity, Zirmed etc) using web service or SFTP.
Handle Denials
Handle Denial Claims with ease
Follow up with ease
Insurance follow-up and A/R collections / Patient Statements
Payment Posting
Manual EOB and Automatic ERA Payment Posting
Extensive Reporting
Extensive Reporting to manage and control revenue collection
Internal Messaging
HIPAA Compliant Internal Messaging and Task management for Staff/ Patient
Patient Referrals
Patient Referrals module to support marketing efforts
Integrate with Patient Portal
Integrate with VistA-Edge Patient Portal which is controlled & monitored by Clinic/Hospital staff