RCM – Medicare – Claims Automation
An insurance provider makes a payment claim to the payers. The process involves transfer of claim to Guarantor (Patient) when claim amount is not paid by Primary or Secondary Insurance providers and no response is received from Secondary Insurance over roll out periods.
The AutomationEdge bot invokes and downloads weekly Medicare Payment posting report. The automation handles multiple scenarios of payment claim transfer to secondary payor or the patient who is the guarantor.