CLAIMS MANAGEMENT

GAFFEY Claims Management (GAFFEY CM) is the industry’s most comprehensive claims software suite. GAFFEY CM drives results through the use of advanced editing tools. It automates the submission of electronic and paper claims as well as the retrieval of remittances. Reporting for both billing and remittances allows for complete transparency and efficiency in cash collection.

SOLUTION

  • Automates the claims editing, billing, and remittance process
  • Simple, intuitive user-interface with easy access to common tasks and core functionality
  • Results-driven technology that generates the highest clean claim rates, highest initial claim acceptance rates, and industry best performance in AR days and cash flow metrics
  • Seamless note posting back to patient accounting system for clear visibility
  • Applies payer-specific edits and customizable bridge routines
  • Superior automation and support including front and back end eligibility, automated COB, and automated compliance and claim status
  • Dashboard view of all claims and wide range of standard reporting drilling down to the smallest level of detail
  • SaaS-based technology results in:
    • ease of implementation
    • minimal IT involvement
    • no maintenance cost
    • lower total cost of ownership
  • 85%+ Clean Claim Rate

Testimonial

As a midsized community hospital, one of our biggest challenges was that we were seeing a delay in collections due to payer issues and denials. Since adopting GAFFEY’s Claims Management and Remittance solution (GAFFEYCM) in 2014, we’ve seen much higher Clean Claim Rates which makes it more difficult for payers to delay. GAFFEYCM is a user-friendly system that covers all of our claim types and consolidates remittance delivery from all of our key payers. Having the ability to efficiently pull up a claim and have the EOB attached is a game changer for us. Maybe the nicest part of all is the personal attention we get from GAFFEY’s Customer Service group. Their support team has always been there when we need them, and when we send a work order or place a call, they get right back to us.

~ Regional Medical Center