Medical claims processing software allows you to submit supporting claim documentation electronically.

Electronic supporting claim documentation yields faster payments, fewer denials and reduced administrative costs

Identifying audit risks and process gaps that create unnecessary paperwork are key opportunities for improvement in most healthcare organizations. The Refyne™ Denials Management platform featuring Refyne Attachments™ facilitates an electronic exchange of supporting documentation, enabling healthcare organizations to transmit documents in support of electronic medical claims – leading to faster payments, fewer denials and reduced administrative costs.

How does it work?

Say “goodbye” to printing, mailing and even faxing documents to payers and health plans. No more hauling stacks of paper records from place to place for shipping in response to claim denials. Instead, Refyne Attachments can be used to “package” your claim attachment documentation in an “electronic envelope” and simply transmit all the information required to adjudicate a claim in a more secure, trackable manner – all with just a few simple clicks.

Solutions for CMS and commercial payers

Claim attachments are supplemental documents providing additional medical information to the claims processor that cannot be accommodated within the claim format. According to the Centers for Medicare and Medicaid Services (CMS), common attachments are Certificates of Medical Necessity (CMNs), discharge summaries and operative reports. They are sent to the Medicare Administrative Contractor (MAC) – either Durable Medical Equipment Medicare Administrative Contractor (DME MAC) and/or A/B MAC with the original claim or in response to a request from a DME MAC or A/B MAC. Similar information may be requested by commercial payers as they work to adjudicate claims. Regardless of who you need to submit attachments to, the Refyne solution enables you to easily do so in a compliant, electronic format.

Refyne Attachments helps your organization:

• Improve acceptance rates for claims requiring supporting documentation
• Experience faster claim turn-around and reimbursements
• Reduce wasted time spent tracking the status of claims
• Eliminate “lost” attachments
• Reduce denied and pending claims
• Streamline workflows by eliminating paper-based processes
• Reduce postage and fax charges
• Provide more compliant document transmissions
• Consolidate software tools into a single, unified system