AAI Specialties Include
Electronic Provider and Claimant Payments
Health care and claimant payment expense consume an ever-increasing percent of the claim administration dollar. By implementing a comprehensive electronic funds transfer (EFT), debit card, and virtual card capability, payors achieve dramatic increases in provider and claimant satisfaction and equally dramatic decreases in overhead, delay, and fraud.
Tele-health is the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
Medical Provider Networks
Quality medical provider networks are the foundation of any effective managed care and quality assurance program. By focusing on quality networks that promote patient and provider satisfaction as well as positive medical outcomes, payors can significantly improve the quality of medical service while greatly reducing unnecessary cost.
Medical Bill Review
The payment of medical bills in today's complicated insurance environment requires payors to reimburse providers based on many complex and ever changing fee schedules, medical codes, delivery systems, and jurisdictions. Sophisticated electronic medical bill review can uncover instances of inappropriate coding and/or service and insure that payment is in accordance with prevailing fee schedules and negotiated rates.
Automated Claims Processing
Claim software automation improves claim outcomes, facilitates uniform custom workflows, and simplifies the integration of multiple specialty managed care services. The result is a significant reduction in average open claim duration as well as medical and overall operating costs
Physician Review Services
These services are an integral part of any claim management effort. They provide a unique peer-review offering for chart and causality reviews and other physician advisory services that are outside of Utilization Review.
Program and System Evaluation and Implementation Support
Installing new program components or software can be one of the most difficult and costly experiences facing a health care organization. Proper planning, configuration, and resource allocation helps insure organizational goals and requirements are met.