Alloy

HealthNautica's Alloy Patient Access solutions optimize the Hospital Revenue Cycle by utilizing an operational intelligence platform that contains multiple powerful tools. Alloy integrates with your HIS through HL7, X12 and other protocols that empower hospitals to maximize reimbursements while minimizing and preventing a wide range of costly errors.

Alloy allows you to measure the effectiveness of various registration and collection methods to provide vital feedback to your staff and patients. This enables users to analyze and forecast more accurately, manage expectations and maximize revenue while minimizing errors, reimbursement delays and denials.

 

Insurance Eligibility

Alloy allows users to verify patient insurance eligibility and benefits for all payers on a single platform in real time or batch with customizable, built-in edits. More than 20% of insurance payment delays/denials are traced to preventable mistakes related to eligibility verification.

Most Healthcare providers charge a fee for every eligibility transaction they enter, but HealthNautica provides unlimited transactions for an extremely low monthly fee. The fully customizable and easy-to-read responses for governmental and commercial payers along with real time integration (with all major EMR systems) and batch/browser capabilities make HealthNautica the premier insurance verification company.

Salient Features and Key Benefits:

  • Real-time and Batch
  • Integrated and Stand-alone
  • Fixed monthly price includes unlimited enhanced eligibility
  • Fully integrated with Registration Quality Manager
  • Standard and Custom registration alerts raised in real time
  • Fully developed meaningful set of reports
  • Real-time integration with all major hospital EMR systems

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    Registration Quality Manager

    The Registration Performance Manager includes a custom set of event-based rules and alerts that assigns accounts to the appropriate user in the Revenue Cycle. Work list filters along with advanced HL7 integration allow for creation of custom registration and real time updating of work queues. All patient or guarantor addresses are automatically verified, validated and all insurance eligibility is fully integrated that reduces return mail.

    Salient Features and Key Benefits:

  • Reduces days in A/R, billing rejections and claim denials
  • Creates automated QA for 100% of registrations
  • Registration Performance Manager syncs with all Alloy products creating a single platform, comprehensive view of account information
  • Increases employee satisfaction and decreases training time for new employees
  • Creates accountability to each registrar so job performance can be accurately evaluated and addressed in a positive manner

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    Self-Pay and Financial Assistance Manager

    The self-pay manager will automate Medicare, Medicaid and commercial insurance checking for all self-pay registered patients. All self-pay accounts are evaluated for financial assistance according to hospital policy and screened for Medicaid qualification according to state regulations. All true self-pay patients are classified by their propensity to pay and an estimated monthly income, household size as well as maximum monthly payment recommendations are provided to the Hospital users.

    Salient Features and Key Benefits:

  • Medicaid and financial assistance wizard is used to streamline application process
  • Instant reduction in A/R days and number of self-pay accounts
  • Improves and standardizes Medicaid application and financial assistance process
  • Using the propensity for payment scoring model, payment forecasting is enhanced
  • Standard and custom reports along with real time dashboards track all activities related to self-pay patients

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