Smart Data Solutions integrates with payers and providers nationwide, offering a host of solutions to make clearinghouse connections easier.
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Our easy-to-use portal gives providers access to the services and information they need and use on a daily basis. The portal allows providers access to both our par and non-par payer lists, allowing them to submit to nearly all payer destinations. 835 data can be viewed and processed through our portal serving as a vital link in the revenue cycle management (RCM) process. Eligibility and claim status requests are clean and straightforward through our simple search interfaces. All of these services provide a comprehensive set of tools allowing providers to submit and retrieve information from payers quickly.
Smart Data Solutions offers connections to both our par and non-par payer lists allowing for easy access to a wide array of payers. If a provider has a practice management system capable of producing 837s, they can be dragged and dropped into a simple upload web interface, or for high volume submissions, regular FTP exchanges can be configured to fully automate the process. If 837 creation is not possible for a physician, our interface allows a provider to enter claim information directly into the web portal just like filling out a standard claim form. Additionally, the portal allows providers to save claim templates allowing the ability to create common claim forms easily by loading the template and updating the date and patient information.
Smart Data Solutions offers 835 destination routing, allowing providers to choose their remittance destination. These transactions can be directed to a provider’s RCM system, other clearinghouse destinations, or can be displayed within the portal as an easy-to-read and understand explanation of payment (EOP).
The portal allows easy access into connected payers’ real-time information systems. Our Provider Portal has claim status and eligibility interfaces which allow providers to quickly get the information they need on-demand without having to phone in requests. This information is in a clean and straightforward display for the provider and the back-end connections fulfill the requests over the CAQH CORE 270/271 and 276/277 protocols, maintaining compliance with the real-time information request mandates.
In today’s ever-changing environment, being able to send information in real-time has become crucial. With the use of FHIR, you will now be able to send non-claim information quickly, without sacrificing information integrity. Smart Data Solutions has the ability to implement a workflow using FHIR, allowing you to receive your most relevant data quickly and in a streamlined format, all while integrating with other SDS services.
Solutions SDS can offer:
For a short period of time (1 month after go-live) some claims could be dropped to paper and mailed to SDS. SDS will designate a PO Box for these claims, and perform OCR/data capture to convert to 837. SDS will also perform outreach in conjunction with the payer to identify the providers that have fallen through the cracks and continue to submit EDI to the wrong clearinghouse. Through outreach efforts, we eventually get all providers to submit EDI correctly, thus, eliminating EDI claims that get rejected at clearinghouses and drop to paper.
Smart Data Stream’s quality control edits fall into the following three categories:
270/271: There are 3 extracts files for this transaction
276/277: There is only 1 extract file for this transaction
Smart Data Solutions can support a wide variety of claim and non-claim document types for your business. If you do not see your document type on this list, don’t hesitate to reach out and ask. It is rare that we cannot find a solution for your unique document type.
The payer does. The payer ID determines destination routes and where claims are to be sent. The clearinghouse does not own the payer ID.
Our tools, solutions, and continued research into new AI and machine learning processes help payers nationwide reduce costs, achieve greater process efficiency, and reduce turnaround times.
