Capario

Connectivity. Solutions. Insight.

Provider Solutions

Capario's Portal Technology - Improving the Business of Healthcare
As healthcare organizations strive to operate more efficiently and improve cash flow, it's often difficult to identify where to start. Automating the revenue cycle process presents a clear opportunity to make changes that will quickly impact your bottom line.

By partnering with Capario, you will have access to a revenue cycle management portal that will speed your healthcare transactions and deliver prompt, accurate payments.
Processing nearly one million transactions daily, Capario is certified by EHNAC, and CAQH for CORE® Phases I and II. Capario's Web portal application is supported by a real-time technology platform that provides you with a powerful claim validation engine that uses extensive payer-, specialty- and HIPAA-specific rules. Together with the advanced editing options that scrub claims for CCI and medical necessity, the Capario portal helps you dramatically improve first-time pass-through rates and accelerate cash flow.

Streamline Office Workflow
Through real-time eligibility verification, extensive, up-to-date coding information and online claim correction tools, Capario's portal enables the submission of cleaner claims which increases first-time pass-through rates, streamlines workflow and speeds accurate payments.

Prior to service, registration staff can check patient eligibility in real time, enabling providers to:

  • Improve time-of-service collections
  • Ensure claims are directed to the appropriate payer, eliminating the expense of resubmission
  • Reduce the need to check multiple payer Web sites or make calls to verify each patient's eligibility, saving staff time

Following service, users can upload and submit claims in real time. Claims are scrubbed for standard edits such as clearinghouse and HIPAA-related edits, and payer and specialty-specific edits. Optional editing services are also available, including:

  • Pre-submission eligibility verification
  • Correct Coding Initiative (CCI) edits
  • Medical Necessity Checking using National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) data sets.

Capario standardizes all information in the portal from claim submission views by payer to rejected claims and ERAs, improving the ease with which users can understand information and focus on what's important. While working claims, providers can use the portal to:

  • Sort and filter claims based on 40 different data fields to easily prioritize the ones that require attention
  • Apply edits to claims in real time using online correction tools
  • Save partially completed claims, flag for another user to review, or resubmit

Real-time Information
With Capario's broad-reaching connectivity to payers nationwide, claim status updates are available within hours, eliminating the guessing game of where your claim is in the processing cycle. Capario processes claims and remittances throughout the day, ensuring you have the most up-to-date information. With real-time claim status inquiries, users gain:

  • Immediate insight into a claim's status with the payer
  • Up-to-the-minute, detailed status updates available in bulk or through each individual transaction's unique tracking number and detailed audit trail

Eliminating the delay in cash flow associated with denied claims, the Capario portal enables you to work by exception, quickly see if a claim is rejected, determine the reason for rejection, validate edits and resubmit—all within minutes. Robust workflow tools allow you to assign claim reworks to specific staff members for improved efficiency, create pre-populated timely filing and appeals letters and correct claims online in real time. And, when secondary claims are necessary, Capario simplifies the process by identifying primary paid claims and automatically creating secondary claims electronically.

Business Intelligence
The portal's advanced reporting capabilities provide in-depth business intelligence reports that help you proactively manage your revenue cycle and identify trends or issues impacting the bottom line. The most popular options include:

  • Top 10 Capario-related claim rejections, top 10 payer-generated rejections and top 10 remittance denials
  • Zero-paid claims for correction and investigation
  • Overview of accepted and rejected claims as well as associated dollar figures

To better manage reports and other revenue cycle related tasks, the portal also gives users the option to save frequent searches for added ease of use in an area called “My Tasks,” further streamlining workflow and expediting day-to-day processes.

A Business Advantage
Whether you're trying to reduce costs, streamline operations or accelerate cash flow, Capario's portal offers the breadth of services necessary to improve your organization's financial health. To learn more, request a demonstration, contact sales by email, or call 800-586-6870.

Capario provides an innovative, Web-based solution proven to help practices optimize their revenue cycle management processes and speed reimbursement.