Medical Bill Review Software
Lunar Eclipse is the Medical Bill Review software component in the TotalEclipse™ package and can be licensed for independent use. With an interface designed by our in-house bill review professionals Lunar Eclipse offers multiple bill entry methods including; image scanning, EDI imports in multiple supported formats, traditional keyed input, and an interface for third party data entry companies that will parse and review bills for required fields before automatically creating them in the system.
Lunar Eclipse also supports flexible workflow process configurations with a custom queue system that allows for bill handler assignments, pre-review instructions, and post-review payment approvals as well as online image displays of both Bills and EORs.
The review processing form automatically re-prices lines in real-time as fields are populated as it references U&C rates, state-specific fee schedules, and customizable coded rules with EMB codes and tool-tip explanations for each adjustment allowing for an automated review that explains itself at each step in the process.
Bills are automatically queued for transmission to a customizable configuration of PPOs in daily batches or, where supported by the PPO, in real-time on a per-bill basis. Non-par provider returns can be automatically re-routed to an available participating PPO.
EORs (also EMBs) are automatically generated and stored upon review completion Lunar Eclipse supports online image viewing, batch printing for mail, and EDI transmission.
- Multiple Bill input and import options
- Workflow Queues that support pre-review instruction and post-review approval
- Online image and document storage
- U&C rate, Fee Schedule, and Rule-based automatic review processing
- EMB Coded review explanations
- Provider-based PPO flexibility and transmission optimization for best turn-around time
- EOR formats in printed, digital image, or digital transmission formats