Patagonia Health has a fully integrated and seamless Practice Management and Billing software. Information from the Electronic Medical Record System flows electronically into the billing module which eliminates double entry and improves accuracy. A comprehensive software suite increases staff productivity and efficiency since tasks such as scheduling appointments, patient reminders, checking patient insurance eligibility, tracking co-pays, generating patient statements and creating financial reports are simplified.

The billing module is electronically connected to 2000+ government and commercial insurance payers including Medicaid, Medicare, LME/MCO, Blue Cross Blue Shield, United, Cigna etc via a clearinghouse. It is compliant to all HIPAA transaction formats including but not limited to 835, 837 and new 5010. The various financial reports in the module allow you to be sure of the status of your business financials at any given time: all this information is available at your finger tips, is always current and can be accessed from anywhere, anytime.

Our product features and capabilities include:

Patient Demographics
•    Enter and track patient demographic (name, contact etc.), insurances (primary/secondary) and authorized services.

Insurance Eligibility Verification
•    Simply and easily check a patient insurance eligibility to reduce claims denials.
•    Within couple of minutes, front office staff can check and receive insurance eligibility, co-pays and authorized services.

Appointment Scheduling & Reminders
•    Comprehensive and flexible scheduling module increases efficiency by scheduling patients, providers and resources.
•    Advanced features such as automatic email reminders help reduce No Shows.

Patient Ledger
•    Patient Ledger keeps track of all claims, payments (by patients, insurers etc), balances and provides a simple and single view of all patient financials.

Electronic Super Bill
•    Notes captured in the Electronic Medical Record software flows into an Electronic Super Bill (ESB). Billing person can quickly and easily review all service charges in one central place and amend charges prior to sending claims off to the payers.

Charge Entry and Scrubber
•    Routine data entry effort can be reduced by presetting fee schedule in the system.
•    Built in data scrubber ensures that clean and compliant claims are submitted to the payers.
•    Billing module automatically submits primary and secondary claims per pre-configured rules.

Claims Submission
•    Included clearinghouse connectivity expedites claim submission and payments. Claims can be submitted either in real time or batches to suit your workflow.
•    Extensive reports are available to view status of claims.

Patient Statements
•    Timely Patient Statements increase collections, reduce effort and accelerate payment cycles. Statements can be created with various criteria (e.g. specific aging or balance) and can be configured to meet your needs.

Payment Auto Posting
•    Billing module receives Electronic Remittance Advise ERA from the payers in the HIPAA compliant 835 format. Received ERA is reconciled against original claims and claims are automatically posted against each patient’s claims.
•    The unique auto posting is a great time saver.

Denials Management and Rejections
•    This module allows you to efficiently understand reason for denials as well as make changes and resubmit claims quickly.

Financial Reports
•    Extensive reports are available to stay on top of financial health of your business.
•    Personalized dashboard can be configured to meet your needs.
•    Numerous standard reports such as business analysis (by claims, by procedures), Activity Summary (by provider, insurance etc.), by procedure codes, by Aging, by Payers help you manage your business efficiently.

Collections Management
•    Increase cash flow by efficiently following up on collections and all accounts payable. Collection reports can be exported and sent to a collections agency.