Revenue Management is a powerful electronic claims processing system that includes automatic payment posting and fully automated claim submission and report retrieval for most payers. Revenue Management can process any type of claim to any payer across the country without monthly or per-claim fees.

Revenue Management works with Medisoft version 16 or higher!

Revenue Management can be used to submit claims and process payments for payers across the country. Revenue Management is approved as a vendor in every state for Medicare (part A and B), Medicaid, and Blue Cross Payers. Revenue Management software can be used to submit commercial claims to any payer that accepts direct claims or you may send claims to the clearinghouse of your choice.

There is even a commercial clearinghouse you can use at no cost to the provider. AVAILITY is a very responsive and capable clearinghouse for over a thousand commercial payers. McKesson has been a vendor partner with AVAILITY for several years. Their enrollment process is handled online and speedy. You can visit their website at www.availity.com.

Revenue Management does not use a print image to process claims. Revenue Management reads the claims directly from the database and marks them as sent, just like the practice management system itself. This is why Revenue Management can process so many types of claims that go above and beyond the capabilities of most clearinghouses or “direct modules” supplied by the practice management system developers. This is also why you can use Revenue Management to post the functional acknowledgements and electronic remittance payment files. What used to take hours now takes only seconds, just a few clicks and it’s done, saving both time and money.

As Revenue Management processes the claims the information is “mapped” into the electronic file format. During this mapping process we can make intelligent decisions about the data in the claim. For example, we can select the proper codes and values to send based on the type of services a patient has received. After mapping, the claims are reviewed against the edit rules to be sure the information is correct before they’re transmitted. The results of this review are shown on the Claim Validation report.

Revenue Management was built from the ground up to be configurable by design. The programmers at McKesson can adapt to changing requirements and new payers without changing the core software, it’s simply a configuration item for them. This is also the reason one program can work for any payer across the country and it gives them the ability to include any information from anywhere in the practice management system in the electronic claim file.