Meeting federal requirements for funding, servicing a rising number of members, and operating on flat-lining budgets are huge challenges for state medicaid agencies. The effective processing of new members and medicaid claims requires timeliness, accuracy, proper documentations, and privacy. And being able to share key information with field workers and associated state agencies is key to providing quick and complete care to clients.
DocFinity provides straightforward access to the information needed to manage information and claims effectively and eliminate the risks associated with human error. You'll also upload information and complete processes from mobile devices, enabling you to expedite processing like claims, appeals, and grievances.
Enrollment | Credentialing | Claims Processing | Appeals & Grievances
Correspondence | Federal Exchange Errors | Delivering Refunds
Explaination of Benefits | Coordination of Benefits | HR Processes
Monitoring Productivity | Contracts
DocFinity® is changing the way you store and retrieve files. It helps you keep your cost per recipient down while expediting turnaround on the processes surrounding Medicaid provider enrollment, member enrollment, claims, and associated wellness efforts, as well as organizational processes. DocFinity tools like Intelligent Capture, Enterprise Content Management (ECM), Records Management, eForms and BPM/Workflow will assist you with:
Securely storing scanned documents, faxes, forms, media files or any type of structured, semi-structured, or unstructured content—including correspondence and HCFAs—so you can find the information you need prior to authorization.
Addressing compliance initiatives by automating file retention schedules, setting staff accessibility rules around documents and images, and recording audit trails for each item held in DocFinity.
Automating the capture of documents and extraction of data for use department-wide, and to share with other agencies who could benefit from the latest information.
Automating and standardizing processes so claims are processed consistently, accurately, and on time.
Image enabling MMIS or other familiar systems to pull relevant documents and data held in other applications to quickly verify benefits and evaluate the medical necessity of services.
The true power of DocFinity comes from integrating it with many of your line of business applications, such as your MMIS and billing system. Your staff doesn't have time to learn a new system. So, by image enabling your familiar applications, your staff can access data, documents, and images held in DocFinity, as well as push data and files to DocFinity, at the click of a button.
Verify coverage automatically before distributing claims to
Improve management of the provider credentialing process.
Automate the enrollment process to mitigate risks,
eliminate missing documents, and minimize compliance
Allow straight-through processing of first-pass claims.
Quickly find information needed to resubmit claims.
When you need metrics to prove that your efforts to create a more digitally efficient environment are working, or to note what’s holding you back, DocFinity can help. DocFinity Dashboards not only reports on activity within DocFinity, but can also monitor your servers, repositories, other systems, and staff productivity within other applications. In real time, view the number of accepted or denied claims, pinpoint bottlenecks due to server overload or under-staffed areas, and monitor repository capacities—all to be proactive about keeping your organization running as efficiently as possible.
Enrollment | Credentialing | Appeals & Grievances
Claims Processing | Correspondence
Federal Exchange Errors | Delivering Refunds
Explaination of Benefits | HR Processes
Coordination of Benefits | Monitoring Productivity
Appeals & Grievances
Federal Exchange Errors
Explaination of Benefits
Coordination of Benefits
Verify coverage automatically before
distributing claims to adjudicators.
Improve management of the provider
Automate the enrollment process to
mitigate risks, eliminate missing
documents, and minimize compliance
Allow straight-through processing of
Quickly find information needed to