Centricity EDI Services
Integrates workflow for claims into your revenue cycle
Centricity EDI Services
Rapid access to the business intelligence and comparative analytics needed to monitor, track, and respond to Electronic Data Interchange (EDI) issues impacting your organization's financial and operational performance.
Accelerate the revenue cycle
Centricity EDI Services is a proven HIPAA compliant all-payer healthcare clearinghouse and proactive services offering that helps you reduce costs and A/R days, while optimizing profitability. Centricity EDI Services enables scheduling-to-payment workflow that electronically connects you to virtually any payer. Centricity EDI Services fully integrates workflow for eligibility, claim information, and remittance data into your GE Healthcare revenue cycle solution to help you improve efficiency and reduce inaccuracies in the medical billing process.
Optimize financial performance and profitability
Centricity EDI Services streamlines financial operations, provides greater insight into financial performance, and helps you identify any patient billing issues before they disrupt or delay payments.
Virtually eliminate manual “corrections” that may result in errors
Centricity EDI Services links you electronically to virtually every payer for the processing of claims information and electronic remittance advice. It automates eligibility verification, EOBs, referrals, and authorizations, while managing attachments, claims and remittances, and claims status checking, reducing unnecessary effort.
An extra set of eyes, without the extra FTEs
Centricity EDI Services provides results-based solutions that help you manage the collection process using fewer resources. Our expert service and integrated software offering can help improve the management of your revenue cycle.
Valuable business insights
By providing a closer look at EDI transaction volumes, file and claim level rejection highlights, and rejection details, Centricity EDI Services helps you identify areas for improvement.
Proven, robust services
More than 2,100 healthcare organizations currently entrust GE Healthcare with their financial success by using Centricity EDI Services to manage over 588 million transactions annually.
We’ll monitor your revenue cycle, so you can focus on patient care. Centricity EDI Services allows your organization to process and track healthcare claims information through the entire medical billing cycle. Beginning with the first patient encounter, your staff can proactively verify health insurance eligibility. Once electronic claims are submitted, Centricity EDI Services provides daily proactive monitoring of all EDI transactions to identify issues and automatically generate claims status inquiries. Thus preventing processing delays—before they can have a negative impact on your bottom line.
Centricity EDI Services can be quickly implemented, and GE Healthcare staff will begin monitoring your revenue cycle performance immediately while also managing the technical backend—so you can focus on delivering healthcare and business processes.
Everything you need to optimize your revenue cycle
Centricity EDI Services offers a robust portfolio of services that enable you to focus on your healthcare business while streamlining processes and workflow.
Eligibility Verification: GE Healthcare’s Eligibility Verification solution through Centricity EDI Services enables you to utilize a highly automated exception-based workflow to verify patient eligibility immediately and improve the ability to collect full payment by informing the patient of their financial responsibility at the time of arrival. Eligibility verification helps you achieve better insurance accuracy with reduced effort on the front end while helping to reduce back-end denials and rejections which further reduces unnecessary delays and costs in the revenue cycle.
Electronic Claim Submission: The solution enables electronic claims submission to over 1000 payers through a single point of connectivity. Centricity EDI Services not only facilitates the electronic submission of claims, but customers can also learn the status of a claim at any point, prevent claims from being lost, quickly understand the root cause for a rejection, fix the problem and resubmit your claim.
Electronic Remittance Advice: Posting claims by hand is a tedious, expensive process that is fraught with the risk of errors and inaccuracies. By enabling electronic claim remittance providers can post remittances directly into their revenue cycle management solution automatically, frequently with no manual intervention resulting in faster claim adjudication.
Advanced Payment Tracking: An innovative approach to identify missing or late payments. Complex predictive algorithms determine when payments should be received and will notify the user of late or missing payments.
Integrated Auto Claims Status (AutoCSI): AutoCSI takes action on the missing or statistically late payments identified by the Advanced Payment Tracking system. Claim Status Inquiries are automatically generated for claims that are late or likely missing. Late claims status and responses are seamlessly routed directly into native revenue cycle workflows and task engines. This functionality reduces staff time and accelerates the revenue cycle by automatically identifying unpaid claims and submitting Claim Status requests to payers.
Denial and Rejection Management: Automated and integrated workflow tools bridge together GE Healthcare’s EDI clearinghouse and proactive services with work lists within your revenue cycle to manage the claims that either failed to pass up-front edits or that were denied for payment by the payers. Denial analysis and reporting capabilities offer a thorough analysis of potential problems related to their data entry, coding, and key business processes, enabling customers to make better informed decisions with less time and effort.
Payment Automation: The Centricity EDI Services Payment Automation solution enables you to to receive process and post third-party payments electronically with minimal manual effort. Now, instead of staff wasting time sorting mail, matching both paper and Electronic Remittance Advice (ERA) to expected payment, posting third-party payments, creating deposit tickets or making trips to the bank, GE Healthcare’s Payment Automation offering enables complete automation of these tasks.
Hosted Claims Manager: Centricity EDI Hosted Claims Manager is a rules-based, front-end clinical editing tool that allows you to review professional and institutional claims before submission in order to help reduce claim denials, shorten your accounts receivable cycle and increase the rate of collections. The solution allows real time scrubbing prior to claim submission, helping to reduce claim denials and costly audits, detects when invoice is incomplete before claim submission, helping to improve the revenue cycle process and helps to speed up reimbursement and decrease days in A/R because claims are more likely to be compliant the first time they are submitted.
Payment Reconciliation: Matches bank deposit files with Electronic Remittance Advice (ERA) files to confirm that the money has been received by your financial institution and that it is safe to post the ERA file in your practice management system. Payment Reconciliation decreases costs by greatly reducing the manual task of reviewing ERA files compared to bank deposit files. The solution’s exception-based workflow easily identifies ERA files that have not yet received funding or deposits that have not yet received the corresponding ERA file, so you and your team can focus on other important tasks such as establishing additional ERAs and EFTs.
Advanced Reporting Powered by Reimbursement Analytics: Extends EDI reporting capabilities by offering advanced business intelligence and analytic reporting mechanisms to report on electronic payment information. The tool provides actionable current and historical information to help you identify and address factors driving reimbursement delays and other issues impacting the financial health of the practice. Advanced Reporting powered by Reimbursement Analytics offers a customizable dashboard, easy to build ad-hoc report writer and customizable alerting system to provide the tools to understand where the financial challenges may be within your organization. Furthermore, it provides customers comparative data to assess performance against state and national peers within their same specialties.
Fully HIPAA compliant, CAQH® CORE Certified and ENHAC Accredited.
Centricity EDI Services helps enable organizations to reduce A/R
- Most customers of Plexus Management Group maintain A/R days in the mid-30’s to mid-40’s despite billing complexities1
- Using Hosted Claims Manager, Children’s Orthopaedic and Scoliosis Surgery Associates were able to decrease days in A/R by 10% - 15%2
Customers using Centricity EDI Services can reduce their denials and rejections and receive payments faster
- 98% of claims at Plexus Management Group go out clean the first time due to their use of Hosted Claims Manager1
- Using Hosted Claims Manager, Children’s Orthopaedic and Scoliosis Surgery Associates initiated a three-year run of zero clinical denials2
- After implementing Hosted Claims Manager, Children’s Orthopaedic and Scolosis Surgery Associates received payments 22% faster2
Centricity EDI Services can help customers ensure eligibility information is captured up front
Six months after implementing Eligibility and completed an optimization project, University Physicians, Inc. were able to demonstrate the following benefits:3
- Increased eligibility verification rate from 77% to 93%
- Decreased eligibility denials from 2.5% to 1.42%
- Increased eligibility automation from <5% to 92.8%
Centricity EDI Services Payment Automation can help customers to spend less time on manual payments
After implementing Payment Automation, Coastal Carolina Health Care realized the below benefits4
- 8% less time spent submitting claims, rectifying denials and issuing patient statements, resulting in accelerated cash flow within 30 days after implementation
- Virtually no manual effort required for payment processes
- Staff can devote more time to follow-ups on patient eligibility, insurance denials for new treatments, new government programs
- Ability to focus on patient collections, and payment and patient account analyses
1. Plexus Management Group Case Study, 2016
2. Children's Orthopaedic and Scoliosis Surgery Associates Case Study, 2015
3.University Physicians, Inc. Case Study, 2013
4. Coastal Carolina Health Care Case Study, 2013
Millman Derr Center for Eye Care moves all clearinghouse business to Centricity EDI Services.
“I have been in the medical billing field for 35 years and have never received the high quality support that I receive from GE Healthcare and Centricity EDI Services. We recently moved all our Clearinghouse business to Centricity EDI Services. Since go-live, 100% of our Medicare and BCBS of Michigan claims are managed by Centricity EDI Services which has personally freed up approximately 10 hours per week on Medicare claims and five hours per week on BCBS of Michigan claims. This time savings has allowed me to focus on the high-value exceptions, which reflects in our A/R days decreasing."
Millman Derr Center for Eye Care
Primary Care Health Partners focuses on high cost/high value exceptions with Centricity EDI Services
“Centricity EDI Services provides ‘one-stop-shopping’ for Primary Care Health Partners. The EDI processes are seamlessly integrated into our revenue cycle workflows and allow our staff to focus on high cost/high value exceptions. Using the solution we closely track and trend payer rejections and denials. Our rejection/denial rates are consistently under 4% and our average days in A/R are at 23 days. In addition, 95% of our claims are processed within 45 days and posted within two days. This is especially important at year end when trying to account for ‘payments in transit’. Previously, it took weeks for our remit posters to close year end because so many payments were ‘in transit’. Now year-end closing takes only a few hours. We don’t believe this success would have been possible without the seamless scheduling to payment workflow and proactive services that Centricity EDI Services provides."
Manager, Strategic Initiatives
Primary Care Health Partners
Lamprey Health enjoys excellent software and support with Centricity EDI Services
“We selected Centricity EDI Services based on the workflow efficiencies, integration, reporting and support that GE Healthcare provides. At my organization, the software tool is just as important as support and we felt that other companies couldn’t compete with the seamless integration provided by Centricity EDI Services. I could talk forever about the phenomenal support we’ve received from day one. The transition to Centricity EDI Services was the easiest switch we’ve ever made. The ongoing support provided by GE Healthcare has been wonderful as well, and is frankly more important to us than go-live support. We couldn’t be happier with Centricity EDI Services.”
Business Analyst & Systems Developer
Lamprey Health Care
Centricity EDI Services
GE Healthcare offers a number of services in support of Centricity EDI Services. GE Healthcare standard application support services include:
- Production control and proactive monitoring services to help reduce lost claims
- Implementation services
- Process improvement consultative services
- Telephone and eService support for general application inquiries and issues, provided by support services representatives
- 24-hour critical issue coverage for hospital applications
- Issue resolution related to standard Centricity EDI Services
- Automated case management via eService
- Account Management services focused on helping you optimize the value of your GE Healthcare system
- Electronic copies of application documentation for each installed product
- Periodic delivery of customer tools that support customer self-sufficiency and super-users
- Periodic product version releases or updates supported by documentation materials
- Periodic complementary educational seminars including regulatory updates
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September 19-22, 2018
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WatchCentricity EDI Services helps Children's Orthopaedic Improve Payment Speed
Centricity EDI Services for Centricity Business Demo
Watch this demo to learn how you can leverage Centricity EDI Services to help increase administrative efficiencies and boost financial performance. By combining a single vendor schedule-to-payment workflow that integrates EDI transaction data into Centricity Business, GE Healthcare has developed a solution that can help you address issues before they negatively impact cash flow.
Closing the Gaps in Care Through Health DataExchange
WESTMED Medical Group maximizes performance by centralizing its business office and streamlining workflow
St Vincent Health reduces cost to collect and lowers A/R days
University Physician, Inc. improves eligibility verfication process
Children's Orthopaedic and Scoliosis Surgery, LLP improves claims process, enhances communication and improves job satisfaction
Coastal Carolina Health Care spends less time submitting claims, rectifying denials and issuing patient statements
Centricity EDI Services Solution Brochure
Centricity EDI Services Payment Automation Brief
Centricity EDI Services Hosted Claims Manager Brief
Qual Choice of Arkansas
Arizona Blue Cross & Blue Shield
Communicity Partnership of Southern Arizona
California Blue Shield
California Medicaid (Santa Barbara Regional Health Authority)
California Medicaid (Partnership Healthplan)
Colorado Choice Health Plans
Washington DC Medicaid
Delaware Blue Cross & Blue Shield (Carefirst)
Florida Commercial (Capital Health Plan)
Georgia Muscle Skeletal Networ
Louisiana Blue Cross & Blue Shield
Massachusetts Blue Cross & Blue Shield
Massachusetts Commercial (Tufts)
Massacusetts Commerical (Beacon Health Strategies)
Massachusetts Medicaid (MassHealth)
Massachusetts Medicaid (Better Health)
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Michigan Blue Cross & Blue Shield
Gateway Community Health
DWMHA - Detroit Wayne Mental Health Authority
Minnesota Commercial (Health Partners)
Mississippi Blue Cross & Blue Shield
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Pennsylvania Medicaid (HEALTH PARTNERS)
Rhode Island Medicaid
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Nationwide Medicare Clearinghouse
WPS (Wisconsin Physician Services) Clearinghouse
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NGS (National Government Services) Clearinghouse ((New York Empire)
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Novitas Solutions, Inc. (Novitas)
Tennessee Blue Cross & Blue Shield
ASK (Administrative Services of Kansas) Clearinghouse
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Nebraska Blue Cross & Blue Shield
Anthem Clearinghouse (West Region)
Ingenix Clearinghouse (ENS - Electronic Network Systems)
Trizetto provider Solutions (formerly Gateway EDI Clearinghouse)
Anthem Clearinghouse (East Region)
Hawaii Commercial (Medical Service Association)
Alabama Blue Cross & Blue Shield
Availity RCM (RealMed Clearinghouse)
Office Ally Clearinghouse
Stones River IPA Clearinghouse **REMIT ONLY**
Ingenix Clearinghouse (Workers Comp and Auto claims)
Connecticut Medicaid (Aetna Better Health)
Change Healthcare (Emdeon) Clearinghouse
Anthem Clearinghouse (Virginia Blue Cross & Blue Shield)
Vermont Blue Cross & Blue Shield
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West Virginia Blue Cross & Blue Shield
West Virginia Medicaid
National Bank Lock Boxes
Fifth Third Bank
National City Bank Lock Box
Bank of America
First Citizens Bank
Sun Trust Bank
Frost Bank - Remit Only
Bank of Oklahoma
Receivable Outsourcing Inc. - ROI
NDS Infoserve Inc.
Simplificare Inc. (dba Simplee)
Professional Office Services, Inc.
Bank of Hawaii
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