Service Helps Avoid Potential Back-End Liability Associated with CARES Act Billing
Pronto Computing, a leading eligibility analytics and services provider to the healthcare revenue cycle management (RCM) market, announced today a discounted eligibility review service to support healthcare providers in the areas hardest hit by COVID-19.
The Pronto Self-Pay Discovery Process for verification and attestation for CARES Act billing is a useful and timely process to ensure that reimbursement is not put at risk. Pronto is offering a lowered rate on its industry leading eligibility review in support of hospitals and health systems most affected by COVID-19.
“After the tremendous effort caregivers have put into treating patients with COVID-19, we are honored to offer a service that ensures hospitals receive the maximum reimbursement they justly deserve,” said Pronto Co-founder Robert Nolan. “Given the financial stress the pandemic has placed on the American hospital system, it is imperative the process of CARES Act reimbursement for self-pay patients be as streamlined as possible.”
Pronto also has developed relationships and connectivity with Medicare, state Medicaid programs and commercial payers providing a more comprehensive search for coverage. In addition, Pronto is a long-standing, established, HETS-approved vendor with skill in addressing the CMS eligibility requirements associated with billing for COVID-19 treatment through the Federal CARES Act program.
Pronto Computing offers providers a thorough and rapid attestation process to ensure that liability is mitigated, and CARES related reimbursement is not at risk. Pronto Computing has the most advanced programmatic search logic in the industry, which was developed using proprietary algorithms to identify missed insurance coverage.
Healthcare providers who have conducted COVID-19 testing or provided treatment for uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020, are eligible to electronically request claims reimbursement through the CARES program. Providers must enroll as a provider participant, check patient eligibility, submit patient information, submit claims electronically, and receive payment via direct deposit. Approval is dependent on available funding and will be reimbursed at Medicare rates.
Pronto searches the patient files for missed insurance opportunities and reports back to providers. Providers are then able to bill the correct payer, allowing for proper maximum reimbursement. The remaining patients without coverage are billed to Optum, the vendor acting as the clearinghouse for the CARES Act funds.
“As a Pronto client, we proactively requested Pronto develop a weekly COVID-19 specific eligibility file in order to ensure compliance with attestation requirements as part of the CARES Act,” said Kevin Adams, Director of Revenue Cycle Management, Anderson Regional Medical Center. “Our team felt strongly that one of the most important requirements of the HRSA program was to ensure no other insurance exists during the impacted period of billing. We feel the extra effort of analyzing an additional weekly file will help us avoid billing the wrong payer and having to write off revenue that is much needed to offset the financial impact of COVID-19.”
About Pronto Computing
Pronto Computing is the leading provider of comprehensive revenue cycle eligibility analytics and tech-enabled consulting services. Leveraging a proprietary re-engineering strategy, Pronto provides a holistic view of the revenue cycle, combining automation technology with workflow efficiency, productivity measurement and key performance reporting. Pronto aligns with healthcare revenue cycle organizations throughout the implementation process and provides advanced consulting services, ensuring that the outcomes are measurable, and objectives are achieved. With a national client base including hospitals and health systems and third-party outsourcing vendors, Pronto ensures that healthcare providers maximize reimbursement. Pronto is a revenue cycle innovator, leveraging task-agnostic automation and low-cost technology to increase quality, and improve revenue cycle efficiency.