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Overview 

Fee Basis Claims System ™ (FBCS) is designed to improve Fee Basis claims management and adjudication. It will bring efficiencies to the processing of claims as well as provide a knowledge base of information needed to strategically guide the decisions made about Non-VA care.

 

Highlights

Fee Basis Claims System ™ (FBCS) is designed to improve Fee Basis claims management and adjudication. It will bring efficiencies to the processing of claims as well as provide a knowledge base of information needed to strategically guide the decisions made about Non-VA care.


 

 

Key Features

What does FBCS do for you?

Improves payment processing time 
Simplifies management and tracking of Fee Claims 
Reduces manual data entry 
Provides standardized, repeatable processing of claims through automated scrubbing and letter generation etc. 
Provides Superior intelligence needed to make a good business decisions 
Reduce Fee expenditures 
FBCS Workflow:

From Authorization through to payment determination, FBCS improves Fee processing by:

Presenting VistA Authorization information in easy-to-use Windows GUI screens 
Providing assistance with Authorization-Claim matching through system intergration 
Scanning all HCFA 1500 and UB forms ultimately eliminating paper processing 
Utilizing Optical Character Recognition (OCR) technology to pull HCFA and UB data fields and automatically processing then through the integrated to: 
Ensure claims are compliant with Medicare guidelines and Correct Coding Initiatives 
Eliminate Bundling/Unbundling errors 
Ensure medical necessaty and IDC-9 / CPT match 
Ensure all codes are at ultimate speficity 
Avoid overused generic codes and catch-all codes 
Automating generation of Veteran letters and provider summary reports 
Electronically sorting workload into individual work queues by routing claims to designated clerks for processing 
Immediately identifying duplicate claims, claims from OIG excluded providers and claims in violation of Medicare guidelines 
Identifying paid claims from Veterans with insurance 
FBCS Benefits :

Provides comprehensive reporting, including: 
Days to pay metrics 
Clerk productivity 
Claim Status Reporting 
Claims paid by Type, Authorization Status, Vendor, Referring Provider 
Claims Denied by Reason Code, Vendor 
Duplicate Claims 
Improved Customer Service: 
Speeds up processing of Fee Claims 
Allows for improved response to claim status inquiries 
Improved Consistancy and Efficiency of Fee Claim processing: 
Ensure that like claims are processed consistenly 
Provides clear picture of Claim status at all times 
Allows for easy claim retrieval through storage and indexing image 
Savings: 
Significant savings will be realized through the ubiquitous scrutiny of Outpatient Fee Claims 
Efficient communication between Fee and MCCR departments will assure that insured Veterans third party insurance is billed for Non-VA care.

Additional Information

 Fee Basis Claims System (FBCS)

Developer Information

Developer: DSS, Inc.

Website: www.dssinc.com

Phone: 561.284.7000

Email: info@dssinc.com

More Information

For more information please contact the Extension Developer

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