Global billing for maternity is ending.
This has been in the news over the last year, covered by outlets like Stat, Healthcare Dive, and CBS.
For health systems and maternity groups, over the next 6 months:
1) you'll go from billing globals to billing by CPT
2) The way you bill each patient might differ based on their plan and where they are in the pregnancy.
Payers like Molina Healthcare Florida transitioned as early as March 1! Others like BCBS Vermont transitioned just this month. We launched the Substrate Maternity Resource Center to help practices with the transition - you can go
- track your contracted payers
- download a customized rulebook for your billers to use
- gather all relevant payer policies
Quick demo below of how it works, and link in the comments so you can get to it yourself! Feedback is welcome.
Announcing the Substrate Payer Resource.
We get a lot of questions from clients around which payers we support and what operations we do for each, so we put it all online and made it public.
The resource also does a few other things. If you need to
- call or fax a payer, check a payer portal, or find a payer id
- Figure out if a payer is late responding.
- Optimize your claims monitoring infrastructure using live payer adjudication timing.
All of that is searchable here, and it's all pulled from the millions of claims that Substrate processes already.
Today we're launching Substrate Posting: automated payment reconciliation for your exceptions.
- Rules Engine handles CARCs and Bundled payments
- Checks duplicates before posting
- Routes PLB reason codes to the right patient or holding account
- Handles payer mismatches, secondary payers, reversals and more.
Whether you're a CFO or finance leader who wants faster month end close, or a COO/RCM leader that just wants your billers focused on actual denials, we can go live in days and post 90% of your ERAs automatically.
Sometimes the payer you check eligibility with is not the one you submit the claim to. There are
- TPAs
- Carve out plans
- coordination of benefit issues.
The Substrate Eligibility Agent cuts through all these to surface the right payer.
Try the Eligibilty agent for yourself https://t.co/739Ugeshqa
#demo
Many payers deny claims for something as simple as a name mismatch. Catch these and more with the Substrate Eligibility Agent
Try the Eligibilty agent for yourself https://t.co/fHlXwDm9hR
#demo
Demographic errors are a common cause of frontend denials.
In this demo we show how to use the Substrate Eligibility agent to detect when the patient might not be the subscriber on the insurance
Try the Eligibilty agent for yourself https://t.co/fHlXwDm9hR
#demo
Today at 3 PM ET: cutting through the AI hype in the revenue cycle. What's real, what's hype, and how to tell the difference. No pitch, live Q&A.
Last chance to register π
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Tomorrow: we start where most AI talk doesn't, the history. Offshoring, BPOs, rules engines, bots. Each solved something. Each hit a wall.
AI claims to scale judgment. Does it? Join us and find out.
π Wed, 3 PM ET
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