Healthcare providers today render services within a complex payor environment. Government, employers, insurance companies, charities typically form part of a major and varied source of healthcare payor groups. Each group, in offering serving as a payor for care seekers, has its own set of policies, procedures, guidelines and limitations that govern payments for patient care.
These payors enter into contracts with healthcare providers or patients. The rules, policies and conditions contained in these contracts are the basis on which the payer will make payment. These contracts terms and conditions can be as diverse as the care seekers they cover. Healthcare providers seeking to manage the eligibility of their patient whilst ensuring optimal care, all within a manual environment will undoubtedly be faced with a monumental task of managing their billing, claims and receivables processes.
E3 Payor Management System provides the ideal solution, automating any or all contracts accepted by the practitioner / hospital and enabling real time and automatic processing of eligibility checks during the ordering process itself.
With this automatic process in place the practitioner or hospital is able to assure themselves that any or all services provided their patients are fully covered. This limits the need to manage denials, collections and delays in receipts due to an improper contract management environment.