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Frequently Asked QuestionsAt this point, you may have some questions about how our solutions can work best for you. While we can’t read minds, we can certainly anticipate some of the issues that may be foremost in your thoughts. Below are questions we’ve encountered when individuals and companies hear about Bloodhound’s innovative solutions. If your question isn’t here, please give us a call at 888.218.0303, or drop an email to sales@bloodhoundinc.com and we’ll promptly get the answers you need – because the better you understand our services, the more you’ll want to use them.#1 – What are the advantages of an ASP-hosted solution? Installing a claims editing system is very time-consuming, as well as a drain on internal resources. Average implementation time is greater than six months, and you can expect to expend more than 2,000 work hours. Operating in an ASP environment, the average implementation time is only 60 days. Expected hours expended are less than 150. Finally, an installed system lays the burden of maintenance directly on you -- the customer. With Bloodhound’s ASP solution, we do all the work for you. #2 – Why are open sources important in claims editing? At Bloodhound, we believe that open communication between providers and payers is the new gold standard, replacing proprietary approaches of the past, and it is why we are so committed to solving potential problems in the common ground, before they enter the system. One of the reasons that editing software systems have been cited in provider lawsuits is because many edits are applied to claims without explanation. Without sufficient support documentation or references to industry-accepted standards, installed software edits can antagonize providers. At Bloodhound, our rules are based on nationally recognized coding standards (CMS, CPT, etc.), plus we provide the source author, detail and text for each edit message in our web tools that are available to both payers and providers. #3 – Why is scalable architecture important? Bloodhound’s ClaimsGuard™ service was designed from the beginning to be intrinsically scalable. In this way, adding new clients, or additional lines of business from existing clients, does not affect the performance of any production accounts. Bloodhound can quickly scale from several thousand to several million claims depending on client needs. #4 – How does Bloodhound ensure that coding is up-to-date? How up-to-date is it? One of the inherent advantages to the ASP configuration is its ability to update edit sets within days of release by the parent agency, at the same time ensuring these updates are transparent to the client. ClaimsGuard™ content developers use the latest in workflow automation technologies to ensure that each core-edit source is electronically monitored for change notifications, which then trigger internal Standard Operational Procedures (SOPs). #5 – Can prospective customers test the ClaimsGuard™ system prior to signing on with Bloodhound? Yes, Bloodhound will run a sample of historical claims data so that you can actually see real results. Typically, we will ask you to provide between six months to one year of paid claims data. Once the data has been run, a member of Bloodhound’s clinical team personally reviews the findings with you. #6 – What is ClaimsGuard™’s level of HIPAA support? The following revisions of the ANSI X.12 specification are available through our technology: X.12N 4010 and X.12N 4010-A1. ClaimsGuard™ currently accepts the following ANSI X.12N transactions: Enrollment, Eligibility, Claims, Service Review, Claim Status and Claim Payment. Through the same technology, all the standard healthcare code sets are fully supported: Claim Adjustment Reason Codes, Claim Status Codes, Claim Status Category Codes and Provider Specialty Codes. #7—What types of ongoing support can Bloodhound clients expect to receive? At Bloodhound, we do not disappear once ClaimsGuard™ is up and running. Following integration and customization, our clients are supported by ongoing consulting help and self-service web tools. Our account teams work with clients to get them up and running and then continue to work with them by providing hands-on quarterly reviews and customized ad hoc reporting which help provide clearer insight into business practices and better understanding of the impact of reimbursement policies. Further support is just a phone call or email away. To further empower our clients, we provide online tools that let health plan staff and providers view all edits and their sources for each claim. |
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