Pre-bill: Confident Claim Submission
Our OPPS Calculator determines reimbursement for hospital outpatient claims, and identifies line-items that will be rejected, denied, subject to payment reductions, or complexity adjustments, based on the CMS Integrated Outpatient Code Editor (I/OCE) specifications. OPPS Calculator also provides users with outlier reimbursement amounts for qualifying claims.
For claim preparation, OPPS Calculator identifies coding issues that might otherwise result in denials or line-item rejections, and provides a detailed explanation of the issue. This helps your team assure a clean claim is submitted the first time.