Credentialing

Pollux Systems, Inc. will assume your credentialing responsibilities from day one. We have years of expertise in working with countless payors and specialties from across the country. We also utilize software and technology to eliminate the potential for stalled claims.

 

Coding and Compliance

Pollux Systems, Inc.’s Coding and Compliance team is comprised of in-house, certified coding expertise in conjunction with cutting-edge, computer-assisted word recognition technology. We will implement a compliance program that consists of continual in-house quality assurance audits, but also includes an annual “third party” auditing process to ensure maximum compliance levels.

 

Claim Submission

Pollux Systems, Inc. provides direct electronic processing (EDI) of claims to all major payers. We also have access to submit to those payers that do not support direct submission. There are no clearinghouse costs passed to your practice, and we submit claims in a timely manner in accordance with established standards.

 

Payment Posting

Pollux Systems, Inc. posts and deposits payments timely and accurately for immediate balancing and deposit verification. EOBs are scanned and indexed for easy retrieval and efficient denial management. We have processes in place to review payers for ERA (Electronic Remittance Advice) and EFT (Electronic Funds Transfer) capabilities, so you receive your payments faster.

 

Contract Variance

Pollux Systems, Inc. provides an insurance contract variance solution to verify that your current reimbursement levels are accurate. Our enterprise-level revenue cycle management software is capable of measuring these variances instantly. Contract variance can increase revenue, but also proactively identify and avoid mass recoupment liability.

 

The Start Up / Go Live

Pollux Systems, Inc.’s client Start Up process is well documented and defined. We take a very “hands on” approach to implement the plan and create process continuity between us. Our shared goal is to smoothly transition you to our solutions, while simultaneously keeping your cash flow stabilized.

Interface Development

Pollux Systems, Inc. will develop the interface needed to import your billing data into our enterprise level, revenue cycle management system. Our in-house Information Technology Team has years of experience creating interfaces with many practice management systems.

 

Charge Capture

Pollux Systems, Inc. has built processes to capture all charges efficiently whether we receive them electronically or on paper. Pollux will take the extra steps to capture and charge all services provided by the practice. We understand the importance of obtaining the correct information on the front end to eliminate stalls on the back end.

 

Log Reconciliation

Pollux Systems, Inc. has developed a proprietary log reconciliation system that reports variances in comparisons (electronically or manually) between a patient log file of services performed to charges currently entered into our system. This process is to ensure that all service rendered are captured and timely charged.

 

A/R Management

Pollux Systems, Inc. Insurance Resolution process is aggressive, highly detailed and effective in tracking denials, overseeing files and receiving a timely response. We have developed specific software tools and processes to effectively manage and reduce denials, thus improving your practice’s payment cycle and cash flow. We electronically batch all denials and non-response claims into Stalled Claims Service Centers. These Service Centers are worked daily in accordance with well-defined throughput standards.

 

Patient Solutions

Pollux Systems, Inc. includes a patient payment portal that interfaces with our patient statements. We submit statements to patients within hours of patient liability being established. Our United States based customer service team will serve as a seamless extension of your office. The patient has the option to received “e-statements” (email statements). Our statement and payment portal solution is patient-friendly and compliant.

 

Credentialing

Pollux Systems, Inc. will assume your credentialing responsibilities from day one. We have years of expertise in working with countless payors and specialties from across the country. We also utilize software and technology to eliminate the potential for stalled claims.

 

The Features

  • Provider enrollment services for all insurance credentialing
  • Experienced credentialing staff to manage all aspects of the credentialing process through state of the art software
  • CAQH and NPI maintenance

 

The Benefits

  • Improved cash flow
  • Closing gaps on credentialing issues
  • Increased client staff productivity
  • Increased number of clean claims and reduced days in AR

Interface Development

Pollux Systems, Inc. will develop the interface needed to import your billing data into our enterprise level, revenue cycle management system. Our in-house Information Technology Team has years of experience creating interfaces with many practice management systems.

 

The Features

  • Input of multiple formats from a facility
  • Customized built-in billing rules
  • Demographic-based dictated reports and log reconciliation

 

The Benefits

  • Reduced error in data entry
  • Full-download price advantages
  • Higher clean claims and reduced days in AR

Coding and Compliance

Pollux Systems, Inc.’s Coding and Compliance team is comprised of in-house, certified coding expertise in conjunction with cutting-edge, computer-assisted word recognition technology. We will implement a compliance program that consists of continual in-house quality assurance audits, but also includes an annual “third party” auditing process to ensure maximum compliance levels.

 

The Features

  • Provide a basis of recommendation for audit findings
  • Add/correct missing modifiers
  • Identify adequacy of documentation to provide procedure

 

The Benefits

  • Lower rate of claim denials
  • Claims coded to optimize collections
  • Helps train all coding staff

Claim Submission

Pollux Systems, Inc. provides direct electronic processing (EDI) of claims to all major payers. We also have access to submit to those payers that do not support direct submission. There are no clearinghouse costs passed to your practice, and we submit claims in a timely manner in accordance with established standards.

 

The Features

  • Pre-remittance support edits
  • New payer set up and reports
  • Claims submission edits (NEIC)
  • Electronic Remittance Advise (ERA) processing and verification

 

The Benefits

  • Automated billing process for primary, secondary and tertiary processes
  • Timely response and adjudication

Patient Solutions

Pollux Systems, Inc. includes a patient payment portal that interfaces with our patient statements. We submit statements to patients within hours of patient liability being established. Our United States based customer service team will serve as a seamless extension of your office. The patient has the option to received “e-statements” (email statements). Our statement and payment portal solution is patient-friendly and compliant.

 

The Features

  • Patient statements and precise informational letters designed to help patients meet their financial obligations on the first mailer.
  • Immediate patient liability through online submitted statements
  • US-based customer service department
  • E-statement and payment portal options

 

The Benefits

  • Collections are improved
  • Maintains a positive patient/practice relationship
  • Eases communication to patient from practice

 

The Start Up / Go Live

Pollux Systems, Inc.’s client Start Up process is well documented and defined. We take a very “hands on” approach to implement the plan and create process continuity between us. Our shared goal is to smoothly transition you to our solutions, while simultaneously keeping your cash flow stabilized.

 

The Features

  • A hands-on approach from our company to yours
  • Shared goal of software vision

 

The Benefits

  • Working together for solutions
  • On-going training and help

 

Charge Capture

Pollux Systems, Inc. has built processes to capture all charges efficiently whether we receive them electronically or on paper. Pollux will take the extra steps to capture and charge all services provided by the practice. We understand the importance of obtaining the correct information on the front end to eliminate stalls on the back end.

 

The Features

  • Interface development to interface to the revenue cycle management system
  • Weekly and monthly validation of charges
  • Feedback exception reports for research

 

The Benefits

  • Ensure complete charge capture
  • Potential Increase in revenue
  • Identify potential gaps in the client workflow process

Log Reconciliation

Pollux Systems, Inc. has developed a proprietary log reconciliation system that reports variances in comparisons (electronically or manually) between a patient log file of services performed to charges currently entered into our system. This process is to ensure that all service rendered are captured and timely charged.

 

The Features

  • Established throughput standards monitored to ensure timely filing of missing charges.
  • Electronic vs. Manual log comparison of services performed vs. Charges entered

 

The Benefits

  • Keeps current records up-to-date
  • A simpler solution to accurate record keeping

Contract Variance

Pollux Systems, Inc. provides an insurance contract variance solution to verify that your current reimbursement levels are accurate. Our enterprise-level revenue cycle management software is capable of measuring these variances instantly. Contract variance can increase revenue, but also proactively identify and avoid mass recoupment liability.

 

The Features

  • Compare contracted insurance allowable with reimbursement from payors
  • Measures any variance to ensure accurate reimbursement
  • Identifies and avoids recoupment liability

 

The Benefits

  • Ensure compliance with network contracts
  • Measures all variances easily
  • Increases revenue

 

A/R Management

Pollux Systems, Inc. A/R Management process is aggressive, highly detailed and effective in tracking denials, overseeing files and receiving a timely response. We have developed specific software tools and processes to effectively manage and reduce denials, thus improving your practice’s payment cycle and cash flow. We electronically batch all denials and non-response claims into Stalled Claims Service Centers. These Service Centers are worked daily in accordance with well-defined throughput standards.

 

The Features

  • Manages and reduces denials
  • Increases cash flow and payment cycle
  • Daily connectivity to Stalled Claims Service Center

 

The Benefits

  • An increase in revenue
  • Higher level of accuracy in tracking payments
  • Ease of communication

 

Payment Posting

Pollux Systems, Inc. posts and deposits payments timely and accurately for immediate balancing and deposit verification. EOBs are scanned and indexed for easy retrieval and efficient denial management. We have processes in place to review payers for ERA (Electronic Remittance Advice) and EFT (Electronic Funds Transfer) capabilities, so you receive your payments faster.

 

The Features

  • Scanned and indexed EOBs
  • Reviews payers for ERA and EFT capabilities

 

The Benefits

  • QA Process
  • Accurate and timely payment balance
  • Faster payment received