Chorus Claim Services Can Save The Average Health Center Up To $40,000 Or More In Annual Claims Processing Costs!*

Industry claims processing data reveals

• 30% of All Claims Are Denied Initially
• 35% of Initially Rejected Claims Are Rejected Again At Least Once
• Up To 10% of Rejected Claims Are Never Collected

Unlike claim scrubber services that perform only the Level 1 or Level 2 edits necessary for basic submission, Chorus's claim scrubber provides unlimited claim checking before submission using all seven recommended WEDI/SNIP levels just as a payer would. Provides the specific information necessary to correct and submit error-free claims!

All Clearing Houses: 25%-30% Payer Rejection Rate

Level 1 - Syntax/Integrity Testing
Level 2 - Syntax/Requirement Testing

Chorus Claim Services: 0% - 2% Payer Rejection Rate

Level 3 - Financial Edits
Level 4 - Referential Integrity/Situational Testing
Level 5 - CPT/ICD-9 Valid Code Set Testing
Level 6 - Specialty Lines of Service Testing
Level 7 - Payor Specific Edits (Updated Daily)

Checks

Procedure coding for compliance with CCI policies, gender and age restrictions, medical necessity using CPT/ICD9 crosswalk data, and the ordering of procedures for maximum reimbursement.

Checks diagnosis coding using valid primary diagnoses, proper levels of specificity, and the inclusion and ordering of any required accompanying diagnoses. Checks situational/conditional and service/procedure fields to insure they are reported, if required. Checks date field consistency, e.g., date of onset is on or before date of service. Checks Compliance with payer-specific editing rules (Medicare, Medicaid, Aetna, etc.).

Expanded Reporting Capabilities

Extensive reporting capabilities in easy-to understand formats include:

• Error Reports showing claims in error - before claims are submitted.
• Payer Response Reports.
• Submitted Claims Report.

Keeps Rules Up To Date Electronically

When you deploy Chorus Claim Services, you can be assured that all the necessary lookups and rules are included now and in the future. These include:

• Current ICD9 Codes.
• Current CPT/HCPCS Codes.
• Continuous Electronic Rule Updates at no additional charge.

HIPAA Compliant

Chorus Claim Services are fully HIPAA compliant. All outbound claims are HIPAA 837 compliant.

* Average CHC Profile: 7 billable providers with 17 encounters/day; 20 days/month generating a monthly total of 2380 claims per month.