How myQ Enhances Your Insurance Claims Management

What could a workflow tool named myQ possibly do to streamline insurance claim follow-up? And, really, what would an ideal, everything-in-one-spot tool even look like? It would have to be something that prioritizes and stratifies claim follow-up activity across all payers, tracks productivity in real-time, performs root-cause denial trending with vigorous and booming reporting, and everything in between.

how-myq-enhances-your-insurance-claims-management.jpgWe’ve found that too many healthcare organizations have a few (or many) “holes” in their ability to clearly determine what to work on first—and next—when handling insurance follow up; they only have pieces of an ideal workflow, not the whole shebang. That’s why we developed myQ, an all-in-one package that can handle all your claims management needs.

It started as a simple drawing on a whiteboard. We needed the ability to strategically assign and prioritize large volumes of claims to our insurance reps for resolution. The majority of billing systems that providers use today rely on insurance specialists to self-manage assigned inventory. Our vision was to create a tool that allowed the specialist to focus on the process of working the next insurance claim rather than waste time filtering, sorting, loading, etc. within a traditional work queue to find their focus. We worked tirelessly to bring myQ into production in a very short time. Now, a few years later, it has grown into a full-fledged, unique engine that powers our insurance follow-up solution for our clients.

Here’s how we use myQ to enhance your insurance claims management.

At the Surface Level

myQ is a proprietary workflow driver that removes the guesswork from claim follow up.

myQ answers the question, “Why is this claim on my list?” and subsequently tracks the insurance specialist’s actions to move the claim forward toward payment. Totally unique in the industry, this web-based application prioritizes and stratifies claim follow-up activity across all payer types including Medicare, Medicaid, Blue Cross/Blue Shield and UnitedHealthcare, along with all third party administrators. It tracks real-time staff productivity visible to both the insurance specialists and their management team and inventory can be easily reassigned dynamically to drive specialist accountability without the effort of a technical resource. myQ offers robust reporting, including claim touches, time management movements and root cause denial trending, delivering the ability to easily order and then resolve accounts without the need to self-manage the backlog. Best of all, the activity performed in myQ can be easily exported and uploaded to any provider's host system(s).

What It Does and When We Use It

MediRevv utilizes your host billing system (Epic, GE, etc.) as the main work driver and source of record. This is where insurance specialists must request insurance claims, transfer balances, update insurance information, and process transactions.

We use myQ as a supplemental tool that’s leveraged in an engagement to improve productivity under these common circumstances:

  • When you are unable to create effective work queues in the host system for us to track activity.
  • When you are only able to create one work queue in the host system for a large volume of claims assigned to us. which creates inefficiencies for multiple specialists to work from simultaneously.
  • When you are unable to provide us the ability to track specialist productivity within their billing system.
  • When you need to track root case or adjustment analysis that the host system cannot capture accurately.

myQ Advantages

We use myQ as a supplemental tool to your host patient accounting system, with data easily and seamlessly shared from host system to myQ and vice versa. Through the seamless integration of both technologies, you’ll get these benefits:

  • Robust specialist productivity analytics are readily available to be shared.
  • Specialist has the ability to work all related claims for the patient with easy access.
  • Inventory analytics including claim touches, root cause for non-payment and activity results are obtainable.
  • Notes of specialist activity can be uploaded into client host systems.
  • MediRevv supervisors and managers have the highest levels of visibility to inventory control and strategy deployment versus client host system that relies on the specialist to self-manage a client controlled work queue.

To Sum it Up

myQ has grown to be an outstanding time-saver for our A/R specialists in resolving claims. We do it faster, more efficiently, more completely, and we get it right the first time.

For patients, expediting the insurance claim resolution process means they receive the remaining portion of their bill as quickly as possible.

For providers, it means accelerated revenue as the result of faster resolution, clean up and liquidation of A/R balances.

myQ offers our clients transparency to all work that MediRevv performs on their behalf and their patient's behalf.

For MediRevv, myQ gives us extremely accurate reporting capabilities as well as the ability to right-size our staffing, thereby allowing us to pass our savings on to our clients.

MediRevv’s suite of technologies is intentionally built to increase efficiency, drive revenue out of A/R balances to each client’s bottom line, and remain—unerringly—patient-friendly.

The Bottom Line

We have strong confidence in myQ as a focused, one-of-a-kind tool to help A/R insurance specialists take the most effective next step in getting each claim paid. Time and time again, myQ has exceeded our—and our clients’—expectations. We know you’d see marked improvement in productivity if we were to partner with you, too.

 

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About Terry Reinsager, Vice President, Strategic Integration

Terry Reinsager, Vice President, Strategic Integration

Terry is responsible for scoping and driving process improvement, organizational change and functional strategy projects across and within our business. He works confidently with all MediRevv clients as a trusted leader to create the most effective approach to meet their fiscal and patient-centered needs.

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