Collect Rx
Optimizing AR with the Right Touch at the Right Time

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t’s safe to say that the goal for your health insurance claims is to go through a clean process and to be paid on time. But exceptions may occur as some require sending extra documentation for processing while others need someone to call the payers, prompting them to remit.

Finding such accounts within a massive pool of health insurance claims is a tedious and challenging task that often requires manual inquiry of each claim’s status. The process becomes even more complicated and tedious when it comes to out-of-network claims, where the rules and conditions of reimbursements are mostly unwritten. As the claims process continues to get more complex, healthcare providers need an expert on their side to level the playing field with payers.

Functioning as a leading RCM company since 2006, Collect Rx specializes in helping in and out-of-network providers manage claims and maximize their reimbursements. The company manages their AR and enhances their cash flow, allowing clients to focus on their core operations—delivering the best patient care.

Collect Rx achieves all these with its proprietary business tool CRXIS, which helps maximize reimbursement among providers. By reviewing thousands of accounts and identifying claims that require immediate attention, the company is able to zero in on claims that are likely to result in additional dollars for their providers. The company’s robust CRXIS solutioncalculates the minimum waiting time before declaring an insurance claim as default and identifies claim denials and underpayments, triggering their revenue cycle experts to spring into action.

“What we have created here is a game-changing solution in the claims space. Being able to quickly identify the accounts that require attention, our solution eliminates the need for sifting through every single account, and improves revenue cycle performance,” says Kristina Donahue, VP of Collect Rx.

By leveraging its CRXIS tool, Collect Rx helps healthcare providers view a list of accounts that need special attention. The company’s ability to provide real-time visibility into these accounts enables clients to take timely actions. The solution also empowers Collect Rx to ensure that its customers always work on all default accounts and notifies the company in case of discrepancies.
Specifically designed to streamline out-of-network claims, Collect Rx’s CRXIS is well-versed in working with unwritten rules. It’s a testament to the company’s diverse team of experts who pioneered the out-of-network industry and is laser-focused on improving provider reimbursement regardless of their network participation status. They understand the key aspects of such engagements and take the lead in negotiating with payors to secure the highest reimbursement possible.

Committed to aligning with the growing need for establishing a balance between in and out-of-networkclaims, Collect Rx continues to hire experts who are adept at seamlessly navigating between a providers’ network participation status. Consequently, the organization is among the best at managing the full receivables of both in and out-of-network providers.

“We serve as a one-stop shop provider, capable of offering unrivaled services to healthcare organizations, regardless of their network participation status,” states Donahue. To that end, Collect Rx continues to find the claims and streamlines the transactions between healthcare providers and insurance companies, saving them money and time.