NextGen Charge Review Rules Engine
Eliminate 75% of manual charge data review
The NextGen Charge Review Rules Engine combines custom and specialty-specific rules with automation to review and correct charge data from your EHR before charges are passed to your PM system. Reduce operating costs, capture missed revenue, and accelerate insurance payments.
Understanding automated charge review
Here’s a short overview of the automated charge review workflow and how it enhances medical billing—plus some great examples of how medical practices have benefited from this remarkable medical billing solution.
Advantages of NextGen Rules Engine
- Charge data delivery
- Charge data delivery
- Automatic review
- Charge error resolution
- Full system integration
Charge data delivery
The NextGen Charge Review Rules Engine sits between the EHR and the PM system. Charge data is fed to the rules engine from the EHR.
Automatic review
The rules engine automatically reviews every charge to ensure coding accuracy. If coding discrepancies are not detected, the charges pass immediately to your PM system.
Charge error resolution
If an error is identified, the rules engine either automatically corrects it, or if in-depth review is needed, sends it to billing staff for resolution.
Full system integration
NextGen Rules Engine integrates with your EHR and PM systems. This gives a boost to any existing NextGen Healthcare PM solutions and optimizes operations.
Experience the benefits of NextGen Charge Review Rules Engine
Gain a billing automation partner
A rules engine is the application of artificial intelligence to medical billing. Our team translates your staff’s knowledge into customized rules for automated charge review. The rules engine finds the same coding issues your team would have to find manually.
Save time
The NextGen Charge Review Rules engine fixes billing errors at the front end of the revenue cycle—between the EHR and the PM system. This saves time by reducing the need for later-stage manual review and corrections and preventing denied claims.
Get paid faster
NextGen Rules Engine finds and automatically corrects a significant portion of errors. It increases the accuracy of information delivered to the PM system, which in turn increases the likelihood your practice will send out clean claims and get paid faster.
Reduce tedious workflows
Based on experience, about 75% of charges pass through all rules and go directly into the PM system or are auto-corrected and then delivered to the PM system—these charges don't need any review or correction by your staff.
Free staff for higher-level tasks
Free your staff to focus on other tasks, such as management of pre-authorizations, patient pay collections, or denials. The opportunities for higher-level problem-solving can also reduce stress and enhance workplace motivation.
Capture missed revenue
Charges are automatically reviewed against specialty, custom, and regulatory rules to ensure compliance with payer requirements, quality measures, and value-based contracts. Increased coding accuracy helps ensure full reimbursement.
People are loving NextGen Healthcare
Hear what our clients have to say about our fully integrated health IT solution and specialty-specific content designed to meet the clinical and financial goals of your practice.
Client Testimonials
Duane Sheldon
Director of Revenue Management
Vision Innovation Partners
"We have actually driven our denial rate down to 4.6%, which is pretty good in this industry. We keep a high standard with that."Alex Suarez
Informatics Specialist
Stuart Cardiology Group
"Professionals who work in the delivery of healthcare need to be aware of how much the NextGen Charge Review Rules Engine can impact their business. I truly think that this solution could be an industry standard for any medical billing company or any practice that has billing done inside their office."Vanessa Ayala
Specialty Billing Supervisor
OMNI Family Health
"The NextGen Charge Review Rules Engine has improved our financial outcomes significantly. We have seen a reduction in billing errors and in denials. We're finding areas where we need to improve, making improvements, and seeing fewer errors."
Case Studies in Medical Billing
How automated charge review works in the real world
Case Study
Quick ROI for FQHC with Charge Review Automation
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Case Study
Tapping into the Full Power of a Rules Engine - Stuart Cardiology Group
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E-Book
Automated Charge Review
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Brochure
NextGen Charge Review Rules Engine
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