BlueCard Process Optimization
Maximize revenue from BlueCard claims with smarter routing and automation
RemedyIQ’s BlueCard Revenue Enhancement solution ensures each claim reaches the right payer, increasing yield, reducing rework, and optimizing reimbursement from the ground up.
Increase net reimbursement
Improve reimbursement by routing claims to the optimal local plan based on deep payer analysis.
Streamline workflows
Implement scalable pre-bill processes to reduce manual work and enable staff to confidently bill BlueCard claims.
Reduce rework & vendor spend
Eliminate common errors in BlueCard processing, rework of claims, and costly vendor spend.
BlueCard process optimization
Providers operating in counties with multiple Blue Cross Blue Shield (BCBS) plans face complex claim routing decisions. Without a targeted approach, providers encounter post-payment rework, delayed cash, and unrealized revenue. Many organizations rely on vendors or technology solutions that focus on retrospective fixes with high fees, but these approaches often lack long-term viability and transparency.
RemedyIQ delivers a sustainable, client-owned solution that lives within your existing EMR system–no external AI or third-party software required. Our approach empowers your team with transparent logic, competitive rates, and ongoing support, ensuring long-term revenue enhancement.
Align the right claim with the best plan, every time
Opportunities for providers
- Increase reimbursement - Optimizing BlueCard revenue requires complex claim-routing decisions and a targeted claim-level approach to maximize revenue.
- Reduced cost-to-collet - By integrating automated logic and clear decision trees, providers can eliminate reliance on retrospective claim corrections, vendor interventions, or manual void/rebill cycles—saving both time and operational cost.
- Improve automation - By embedding BlueCard routing logic, providers can automate payer selection and claims routing–minimizing manual input and reducing human error.
- Decrease vendor spend - With optimized BlueCard routing pre-bill, providers can eliminate or reduce the need for external vendors.
- Gain payer insights - Through analysis of BlueCard patient populations, providers gain insights into financial impact and revenue opportunities for contract negotiations.
RemedyIQ's BlueCard optimization process
Within two-weeks, RemedyIQ assesses your BlueCard claims and contract landscape to identify reimbursement opportunities and deliver a clear, ROI-backed roadmap. We then partner with your team to implement optimized routing logic within thirty-days, seamlessly integrated into your existing system. Lastly, RemedyIQ provides ongoing monitoring and support to ensure sustained revenue uplift and long-term scalability.
Assessment
We analyze your BlueCard volumes and contract landscape to identify areas for uplift and deliver a clear, ROI-backed roadmap.
Optimization
We optimize claim routing and implement proven methodologies and workflow changes.
Maintenance & support
We provide ongoing monitoring and maintenance, keeping logic current and aligned with changing reimbursement.
Meet your RemedyIQ partners
With an average of 20 years in healthcare, RemedyIQ team members bring deep expertise from provider, payer, and consulting spaces - spanning revenue cycle leadership, contract negotiation, certified technical Epic support, third-party zero balance underpayment recovery, and more.
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Boosting $5.5M in Annual Revenue: RemedyIQ's BlueCard Optimization
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Meet with RemedyIQ to discuss your challenges and strategic revenue cycle priorities.