Payerpath is one of the leading revenue cycle management and clearinghouse services in the United States with over 300million claims processed annually and 600 million revenue cycle management transactions overall. As part of an organization with more than150,000 physicians, Payerpath provides the credibility, experience and results demanded by both payers and providers. First-time pass rates for claims processed through Payerpath reach 98%, significantly better than the industry average of 90-92%. Only Payerpath's comprehensive suite of internet solutions addresses every step in the reimbursement cycle for healthcare organizations. Whether you are a physician practice, clearinghouse or payer, Payerpath can help your organization succeed in the business of healthcare through improved reimbursement and claim management processes that lead to cleaner claims and faster payments.

What makes us unique?

Payerpath provides innovative patient payment and claims management solutions that improve the management of healthcare financial transactions for providers and payers. Unlike other revenue cycle management companies, Payerpath's suite of Internet-based products and services address each step in the revenue cycle, from eligibility verification through patient collection. Developed and continuously updated with input from our clients, our solutions easily interface with practice management or hospital information systems.

Payerpath believes that it is important to develop close, interactive partnerships with payers and their providers.  This approach allows Payerpath to achieve an exceptionally high level of quality, knowledge and service to its customers and partners which translates to

• Tighter edits, reduced medical claim denials, better reporting and expedited payments for providers and hospitals
• Cleaner electronic medical claims processed quickly and cost-effectively for payers

Most importantly, Payerpath is managed by a team with extensive experience and expertise in revenue cycle management, healthcare financial transactions and information technology. This knowledge gives us a solid understanding of the challenges facing the industry and allows us to develop leading technologies that contributes to the overall success and efficiency of the healthcare community.

PayerPath Services

Whether you are a physician practice, hospital or payer, Payerpath can help your organization succeed in the business of healthcare by improving claim processes that lead to cleaner electronic medical claims and faster payments. Our services address every step in the revenue cycle, from eligibility verification through collection, to create a comprehensive claims management services. By eliminating costly, paper-based medical claim processes, Payerpath can help you streamline office workflow, enhance productivity and boost revenue.

Electronic Medical Claims for Providers

Increased productivity.  Secure transactions.  Enhanced revenue.

These are just a few reasons why providers are choosing Payerpath's electronic medical claim system to help manage their revenue cycles. From insurance eligibility and compliance verification to electronic medical claims transmission and remittance management, Payerpath's products can help you save valuable time and money. The Payerpath Claims Management system allows practices of all sizes—from single physician offices to large group practices—to take advantage of the following.

• State-of-the-art, browser-based Claims & Response Management System for both UB92s and HCFA 1500s
• Interfaces easily with any practice management system - no hardware or software to install locally
• Real-time validation of all electronic medical claims against payer-specific acceptance requirements at a rate of 10-15 claims per second
• Integrated Medicare Fraud & Abuse edits including OCE, NCCI and MN based on F.I.-specific LMRP Bulletin
• Proprietary HIPAA EDI translator that can automatically convert data to necessary file sets (ANSI 835, 837, etc.)
• Medicare Secondary Claims management service matches claim to auto-generated EOMB, then prints and mails the claim to appropriate recipient
• Monthly subscription pricing allows providers to accurately budget their claims management expense

ClearinghouseServices

Leverage Payerpath's dependable EHNAC accredited and HIPAA compliant clearinghouse which today successfully supports over 90,000 providers across the country generating over 500 million transactions annually.

Leverage Payerpath’s nationwide connectivity and services to help grow and expand your business.

Payerpath Clearinghouse serves

• Clearinghouses
• Practice Management System Vendors who aggregate transactions for your providers
• Large direct submitters

Payerpath Clearinghouse offers

• Trusted and reliable service and support
• HIPAA compliance
• Nationwide EDI Claim connectivity to over 900 payers electronically
• Payerpath editing
• Payerpath enhanced reporting
• Remittance processing and connectivity
• Eligibility connectivity
• Lab Orders and Results Connectivity and processing
• eRx Connectivity

We realize that security and privacy are essential to your business and ours. As a result, we are committed to helping your organization address HIPAA requirements by protecting the security of all of the healthcare information that Payerpath processes. Let Payerpath bridge the gap and work through the details of the EDI world while you grow your business.

Payerpath Payer Services

Of the top 3 claims clearinghouses in the nation, Payerpath and Allscripts can help Health Plans realize the savings potential of e-commerce adoption through industry leading web-based solutions

CONNECT DIRECTLY TO 150,000 PROVIDER DESKTOPS

Allscripts Payerpath Payer Services moves beyond the basic clearinghouse. Most clearinghouses only route transactions. Allscripts technology is directly imbedded at the provider location. It is an inherent component of the tools these practices use every day. 

THE TOOLS THAT LINK YOU DIRECTLY TO YOUR PROVIDERS

Direct Connectivity delivers access to our nationwide provider base (150,000+ providers). This yields significant value in the form of higher first pass and auto adjudication rates, increased provider satisfaction, and higher electronic transaction rates, resulting in fewer calls to payers.

Clearinghouse services, still part of our core offering, has enabled Allscripts Payerpath to become one of the nation’s leading clearinghouse vendors. In fact, we process over 500 million transactions annually. Because of our rigorous testing, even transactions that don’t originate from our direct providers meet the high standards that we set for connectivity.

ePrescribe enables providers to create prescriptions right at the point of care. This drives down prescription costs by increasing generics, mail order, and formulary compliance. For the second year in a row, Allscripts is recognized for transmitting more electronic prescriptions than any other vendor. 

Payerpath Portal provides access to a cost effective web-based application that lets your providers submit, store, edit and track electronic transactions—all through a portal private-labeled to your business. This enables you to eliminate the cost, implementation time and risk of developing a non-core application internally.

Adoption Marketing leverages our extensive marketing knowledge and resources to improve key payer metrics. Whether you want increased electronic claim volume, ERA, or eligibility, our direct relationships can help you achieve your goals through customized programs targeted to your physicians.

Gateway provides a comprehensive set of reliable and tested products and services that enhance transaction quality and increase overall throughput. This technology helps simplify the upfront and ongoing demands placed on your IT staff by linking your organization seamlessly with providers through a single point of connection.

Patient Pay Assurance can help providers adjust to the transition to consumer-driven healthcare. We can help payers ensure that their providers receive reliable, fair, and timely payment for services provided, and prevent high-deductible plans from adding to the cost and complexity of healthcare administration.

Our suite of industry-leading products for practices includes Electronic Health Records, Practice Management, ePrescribing, and of course, Revenue Cycle Management. Through these tools, we can put you closer to your provider and the business and clinical decisions they are making daily.

Benefits

• Closer relationships with physicians
• Reduced paper across multiple transactions
• Lower Rx costs through generics and formulary compliance
• Better communications with medical practices
• Cleaner inbound claims (increased auto adjudication rates)
• Reduced provider phone calls
• Lower administrative and technical costs
• Private label mature product offerings

HIPAA Compliance

Nearly every aspect of healthcare and patient information is affected by the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). It continues to be one of the most pressing challenges facing healthcare organizations today.

Payerpath recognizes that HIPAA compliance is an enterprise-wide concern that has major technological, operational, administrative and procedural impacts. We have and will continue to develop, document, implement and maintain the appropriate measures to address HIPAA compliance in each of these areas.

We understand HIPAA's strategic significance and view our compliance efforts as a major corporate initiative. We have undergone a comprehensive security risk assessment and have developed plans to mitigate each risk discovered. Payerpath has designated a HIPAA Security and Privacy Officer who reports to a senior management committee to direct these ongoing assessments and all other HIPAA compliance measures. Additionally, Payerpath is fully certified by Claredi and accredited by the Electronic Healthcare Network Accreditation Commission.

We realize that security and privacy are essential to our business and to yours. As a result, we are committed to helping your organization address HIPAA requirements by protecting the security of all of the healthcare information that Payerpath processes

EDI Payer Enrollment

Providers are often required to submit paperwork to payers associating themselves with the Payerpath Clearinghouse submitter information. We have prepared a comprehensive library of enrollment agreements that are complete with instructions and pre-filled where possible. Please access our Forms Library to download and complete the necessary forms to be authorized for electronic transactions.