About Us
A Tailored Medical Claims Clearinghouse
A Little About Us:
We are here because navigating the complex and time-consuming process of submitting claims, only to face repeated rejections and bureaucratic hurdles, can be a maddeningly frustrating experience for healthcare providers, leaving them feeling like they are stuck in an endless loop of paperwork and red tape.
I, a Cherokee Native woman entrepreneur, founded it alongside my brilliant husband, who serves as our CTO. We take pride in offering tailored solutions to reduce claim denial rates and optimize revenue for healthcare providers, especially those serving Tribal communities. Our user-friendly software ensures seamless claim processing and unmatched analytics for enhanced operational efficiency.
But we don’t stop there – we harness the power of Sharp revenue tools to amplify our impact. With our real-time eligibility checks, coverage discovery, and retro Medicaid capabilities, we leave no stone unturned in maximizing your reimbursements.
At ClaimRev, we believe in the power of personal connection and timely support! We value your time, which is why we provide a single point of contact to eliminate long hold times and impersonal call centers.
SharpClaim™ Processing
Revolutionize claims processing with our custom rules engine which decreases claim denials, boosts operational efficiency, and maximizes reimbursements.”
The innovative EDI parsing software lets you say goodbye to file rejections and hello to more approved claims. Our state-of-the-art technology is built to attempt to get all claims out of the file, regardless of whether the file meets EDI standards. This means that even if one claim in your file is missing a subscriber, SharpClaim™ will still accept 99 of the other claims that are clean, allowing you to focus on fixing the one issue rather than resending the entire file.
In addition, SharpClaim™ provides detailed error messages for any claims that require revision, making it easy for you to identify and resolve issues quickly and easily.
If our system determines that you have already submitted a claim on the same day and the original claim is still waiting to be processed by the payer, we will automatically void the original claim and send a new one in its place
Are you tired of being limited by the capabilities of your medical billing software?
This powerful tool allows you to make small changes to your claims quickly and easily, without having to rely on your billing software. With our user-friendly interface and intuitive design, you’ll be able to mark claims as rejected and identify missing information with ease.
Choose from Pre-Built Modules or Go Fully Custom
We understand that every medical practice is unique, which is why we offer both pre-built modules and fully customizable options. Our pre-built modules are designed to perform a single function, such as updating patient demographics or adjusting charge amounts. However, if you have specific requirements that aren’t met by our pre-built modules, we can create a fully custom solution tailored to your exact needs.
With SharpClaim™, all of your custom edits will be stored in one convenient location, making it simple to track and manage your changes. We’ll also provide clear documentation of each edit, so you can easily see what’s been applied to your claims.
Contact Us Today for Custom Claim File Solutions That Work for You!
ClaimRev Portal
Our portal is your gateway to the processing system. Upload claim files, download reports, and track claim statuses effortlessly. Stay organized and informed with our user-friendly portal
Professional, Institutional, and Dental all have claim editors. 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 and we can create it for you!
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.
