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What is Paradigm?

Paradigm Senior Services offers a robust, AI-enabled revenue cycle management solution tailored for home-care agencies that manage billing across various third-party payers, such as the U.S. Department of Veterans Affairs (VA), Medicaid, and numerous managed-care organizations. The platform streamlines and improves every aspect of the billing and claims process, which includes tasks like eligibility verification, authorization management, and handling state or payer-specific enrollment and credentialing. It also ensures the submission of correct claims, addresses any denials that arise, and facilitates payment reconciliation. By integrating smoothly with popular agency management software and electronic visit verification systems, it allows for the effective scrubbing of shifts, weekly authorization checks, and smooth payment reconciliations, ultimately leading to fewer denials and reduced administrative burdens. Furthermore, Paradigm provides a "back-office as a service" model for healthcare providers, meaning that even if agencies have their own billing teams or scheduling tools, Paradigm can still oversee claims processing as if it were a dedicated, knowledgeable billing department. This adaptability empowers agencies to prioritize patient care, alleviating them from the intricacies of billing operations by entrusting those complexities to experts. In doing so, Paradigm not only enhances operational efficiency but also supports better financial outcomes for home-care agencies.

What is AppealsPlus?

AppealsPlus™ is a cutting-edge cloud-based solution that automatically evaluates ERAs by applying targeted rules to sort ambiguous payments and denials into specific work queues, while also utilizing dashboards and key performance indicators for effective quantitative oversight that informs strategic choices. The regulatory environment is continuously changing and can alter unexpectedly, providing minimal time for both providers and their patients to adjust accordingly. Many providers grapple with uncertainty about their patients' ability or willingness to pay bills after procedures. A common misstep among research, vendors, and software developers is the realization that the term denial is interpreted differently by various physicians, billers, and institutions. To ensure that our solution aligns perfectly with your team's unique requirements, we will facilitate a customized implementation process that spans four weeks. After this initial setup, feel free to contact us anytime with questions or concerns, as we are dedicated to supporting you throughout your entire experience. This ongoing partnership allows for timely adjustments to be made, ultimately improving your overall satisfaction with our service. Additionally, we believe that consistent communication is key to a successful collaboration, ensuring that your needs are always met.

Media

Media

Integrations Supported

Axys

Integrations Supported

Axys

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided
Free Version
Free Trial Offered?

Pricing Information

Pricing not provided
Free Version
Free Trial Offered?

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Paradigm

Date Founded

2015

Company Location

United States

Company Website

www.paradigmseniors.com

Company Facts

Organization Name

Etactics

Company Location

United States

Company Website

etactics.com/appealsplus

Categories and Features

Home Care

Billing & Invoicing
Care Plan Management
Caregiver Management
Client Management
Field Communication
Insurance Management
Payroll Management
Scheduling
Visit Verification

Medical Billing

Claims Processing
Claims Scrubbing
Code & Charge Entry
Compliance Tracking
Customizable Dashboard
Dunning Management
Invoice History
Patient Eligibility Checks
Practice Management
Quotes/Estimates
Remittance Advice

Categories and Features

Medical Billing

Claims Processing
Claims Scrubbing
Code & Charge Entry
Compliance Tracking
Customizable Dashboard
Dunning Management
Invoice History
Patient Eligibility Checks
Practice Management
Quotes/Estimates
Remittance Advice

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