About Us

A Medical Billing Clearinghouse

About our company

Claim Revolution, LLC dba “ClaimRev” is a native woman owned, medical claims clearinghouse. We process; in near real-time, all three claim types.

  • Professional
  • Institutional
  • Dental

lf you would like to improve your cash flow, reduce workload, and spend less time on the phone contact us today for a demo!

A Medical Billing Clearinghouse

SharpClaim™ Processing

SharpClaim™ is a highly scalable and configurable server-less EDI processing system. Using the latest development tools, the healthcare claim software can process any edi standard with little effort and in near real time.

The EDI parsers are created to attempt to get all claims out of the file, regardless if the file is not up to the EDI standards. What this means to you is fewer file rejections and more claim rejections. For example, lets pretend you send a file with 100 claims. One claim in the file is missing a subscriber. In most processing systems, this would throw the entire file out into a file rejection. You would then have to resend all 100 claims after you fixed the one claim in your billing system. With SharpClaim™ however, this isn’t needed. Assuming, 99 of the 100 claims are clean, they will be accepted and ready to send to the payer. The one claim missing the subscriber, will be marked as an error, where you can either fix with the claim editor or fix in your system and resend the one claim.

If SharpClaim™ determines that you already sent a claim in the same day and the original is still waiting to go to the payer. The original claim will be voided and the new claim will be sent instead.

This module allows for making small changes needed on the claim that your billing software might not be able to include. Also, it will let you mark the claim as rejected if something is missing from your claim.

Occasionally, there are times that large changes need to be made to your claim. You can request a edit module. Some modules are already created that do one function, or you can go completely custom for your practice. Your custom edits will always be in one spot and we can easily tell you what is being applied to your claims.

If your billing system wants to send a custom claim file, contact us we can create the parsers to handle it.

ClaimRev Portal

The portal is the window to the processing system. Through the portal you can upload your claim files, download reports, and view claim statuses.

Our claim editors can edit Professional, Institutional, and Dental claims. The editors will provide access to every field that could be possibly sent on an EDI claim format. There are times that fixing a claim in the editor will be faster than resubmitting the claim from your billing software.

This module will let you create your own workflows. The module helps you organize your claims into your own statuses and to specific users. For example, you might want all BCBS claims that reject to go to a specific person to work. You might also want to have a bucket to put claims you need to call the patient about, maybe they need a new member ID. This helps you organize it and not “loose” or “forget” about the claim.

This screen allows for your claim management. You’ll never loose a claim because you can search by many different fields and options on the claim. From this screen you can edit the claim, find ERA’s attached to the claim, plus many other features. If you need a new option or search on a different field just ask.

This module allows for making small changes needed on the claim that your billing software might not be able to include. Also, it will let you mark the claim as rejected if something is missing from your claim.

  • File Acceptance (999) and Claim Acceptance (277)
    These files are available for download right off the File Upload page. Once downloaded you can import the EDI into your billing software
  • Electronic Remittance Advice (835)
    The raw ERA files are available for download for your billing system and all ERA’s have a human readable version on the portal so you can quickly read them without much effort. The ERA is also linked to the claim and available for viewing through the claim search screen.
  • Analytics
    Our specialized data warehouse allows us to create custom analytical reports based on your claims and ERA’s. If possible, we can even interface with your PMS system and build even more specialized reports for your practice.

Available for PMS and Billing systems. If needed we can create a custom REST API so your claims software can interface with the portal or SharpClaim™ features.

Our Team

Biz photo amber

Amber Sharp

CEO

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Brad Sharp

CTO