Sigmund Software, LLC

Sigmund’s clinical service delivery tracking automatically drives the billing process. Invoices are automatically generated in industry standard formats based on bed and program level assignments, appointments and ancillary services delivered as well as authorizations. Sigmund supports a wide range of specialized billing scenarios to satisfy complex combinations of private pay and third party payers. Sophisticated user-definable business rules, extensive controls and automation collectively streamline and expedite the billing process resulting in fewer denials and more rapid reimbursement. Payment, adjustment and collections activities are effectively integrated with front office and back office features. Sigmund is designed to meets the demands of multi-company, multi-program agencies and offers exports to any accounting system as well as specialized interfaces to a range of leading systems.

• Eligibility and Authorizations
• Track detailed funding information for multiple third party and private pay sources
• Quickly access contract information
• Capture detailed benefits and eligibility information, including co-pays, deductibles, limits etc.
• Record pre-certifications (authorizations)
• Automate billing and adjustments with the ability to define complex authorization scenarios
• Create authorizations for days, visits, units, months etc.
• Track detailed notes regarding conversations with payers and guarantors
• Establish fee  schedules and payment plans
• Conduct both external and internal utilization reviews
• Billing and Claims Management
• Bill for inpatient days, outpatient visits, day treatment, months, units etc.
• Automate billing on the basis of program, bed, appointments, authorizations
• Drive billing from ancillary services, medication administration record etc.
• Automate adjustments, remainder and re-billing activities
• Batch bill in payer, program, patient etc. groupings that match your cycles and billing practices
• Generate claims in industry standard formats (UB-04s, CMS-1500 etc.)
• Import demographic, diagnostic and service delivery information automatically
• Sophisticated claim validation ensures proper submissions
• Employ specialized invoice and claim formats for co-pays, private payers and payers or state agencies-specific requirements
• Bill using complex rules such as step-downs, case rates, sliding scales etc.
• Enforce payer requirements for clinical documentation, coding etc.
• Payment and Collections Management
• Record Cash Receipts, Checks, EFTs, Credit Card Transactions etc.
• Automatically or manually assign receipts to deposit slips
• Record Bulk Insurance payments, co-pays, private pays etc.
• During receipts posting, automatically or manually generate invoices, perform adjustments, rebilling etc.
• Record pre-payments, payment schedules, NSFs, Refunds, Insurance retractions (take-backs) etc.
• Perform complex and user-defined adjustments for third party write-offs, bad debt, scholarships etc.
• Transfer credits, balances between multiple payers
• Track Accounts Receivable and generate aging reports by company, payer, patient, contract etc.
• Employ a fully-integrated collections module with call logging and task management capabilities
• Payor Contract and Insurance Management
• Maintain a master list of payers, including insurance companies, state agencies, grants etc.
• Organize funding sources by type, category, company, parent company, plans for billing, collections and reporting purposes
• Track contract effective dates, rates, conditions and scheduled changes
• Identify service specific rates, co-pays, expected amounts, GL codes, billing requirements etc.
• Identify, default and validate payer-specific claim requirements
• Identify payer-specific precertification and authorization requirements
• Track multiple payer addresses for claim submissions, remittance, authorizations etc.
• Track payer contacts and call logs for authorizations, case management, collections etc.
• Manage payer-specific requirements for electronic claims submission, remittance and benefits verification
• Specialized Private Payor Tools
• Take advantage of features designed to enhance billing, collections and customer service for patients and their private payers
• Create flexible pre-payment and installment payment scenarios
• Automatically calculate, bill and adjust for sliding scales and scholarship scenarios
• Batch or individually print specialized patient statements for notifications and collections
• Utilize VIP and Confidential Patient Names to mask identities from staff
• Provide separate accounting for management of patient monies or personal funds
• Bill insurance and other institutional payers in pre-payment scenarios and deduct from patient balances or provide to patients for submission
• General Ledger / Reporting / Closing Tools
• Map your existing multi-company, division and program level general ledger account structure into Sigmund
• Mirror your segments, natural accounts, fiscal periods, years etc.
• Organize, manage and default accounts for various revenue streams, cost centers, adjustment types etc.
• Integrate with external General Ledger systems or take advantage of powerful and flexible exporting functions
• Create manual and automatically generated journal entries
• Employ a wide range of reports to manage revenue, adjustments, receivables, cash receipts, disbursements etc.
• Utilize a comprehensive set of reports and controls to manage closing processes

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