Revenue Cycle Solutions That Work

The InSight Revenue Cycle Solution includes these products:

InSight Medical Necessity^®

Validates medical necessity on the front-end of the revenue cycle. InSight Medical Necessity checks HCPCS, CPT, and ICD-9 codes for medical necessity, provides access to LCDs and NCDs, and generates both general and lab ABNs and statutorily non-covered forms.

InSight Eligibility

Verifies patient eligibility quickly and provides comprehensive coverage information with minimal data entry.

InSight Compliance

Automatically identifies claim errors prior to submission. InSight Compliance processes claims against the Craneware InSight library of payor edits and rules and provides analyses and reports on claims data.

An Optional Workflow and Claim Editor modules provide workflow routing and real-time repair of any claims flagged by our library of payor edits and rules. Claims are routed to the appropriate user and presented in a virtual UB-04 interface so they can be repaired and submitted to the payor in the correct format.

InSight Payment Variance Analyzer^™

Identifies, tracks and helps eliminate revenue lost in the form of underpaid claims.

InSight Denials^®

Drills into 835 remittance data to uncover the root causes leading to denials. InSight Denials analyzes, tracks, trends and reports on denial data and provides workflow tools to distribute denied claims to the right departments and individual team members for resubmission.

InSight Audit^™

A powerful and easy-to-use application designed specifically to address the data-entry, tracking and workflow challenges that RAC Audits, Medicaid Audits, and other payor audits present to the hospital organization. InSight Audit is a comprehensive, web-based audit management tool that manages all of your medical claims audits and workflows from one central location.

Visit craneware.com to learn about Chargemaster Toolkit^® and other Revenue Integrity Solutions™