healthcaretechoutlook

Cirius Group: Streamlining Patient Provider and Payer Relationships

 Mark Ehnen, VP of Sales
Revenue cycle management (RCM) is the lifeline of every healthcare provider’s practice, as this is where all the revenue recognition happens. However, to stay on top of the various changes in government and commercial payer requirements and produce clean, payable claims is a herculean task for providers. Often times, payers reject or deny claims due to issues within the claim that often lead to a loss for hospitals and physicians. Confronting these tribulations with a superior claims editing system, accompanied by direct provider-paid electronic data interchange (EDI), is what makes Cirius Group the ultimate game-changer. “Our product offering is unique as it is equally strong in both the hospital and physician billing environments,” states Mark Ehnen, vice president of sales, Cirius Group. “Prebill Manager edits both UBo4 and 1500 claims with a higher degree of scrutiny to produce cleaner claims that have a direct impact on the provider’s financial performance.”

In addition, Cirius provides dynamic revenue cycle solutions for remittance processing/posting as well as solutions that calculate expected reimbursement across all payers. PreBill Manager, which is their claims editing EDI system, is highly configurable and employs a combination of vendor maintained edits as well as the customsite specific edits, to produce the highest clean claim rates possible. PreBill Manager not just identifies errors, but it also automatically corrects them with precision. Cirius’ customers can design, test, and implement custom edits and respond quickly to the ever-changing payer requirements. Prebill Manager’s direct “provider to payer” EDI and comprehensive claim editing results in an increase in efficiency of billing operations and an improvement in financial performance. Cirius goes to great lengths to configure and test a new system installation, delivering a production ready system within a span of four months, resulting in measurable improvement in billing effiency and financial performance within the first month of production operations.

We will evolve and continue offering the best revenue cycle systems available, and in the process, improve the relationships between providers and payers


Yet another product from Cirius is the Remittance Manager that streamlines the electronic remittance advice processing, automates secondary claims generation, enhances cash posting, and facilitates denial management processes. The third major product offering is the Reimbursement Manager that calculates the expected reimbursement and identifies underpayments.

PreBill 1500 Manager has been enhanced to function with Epic Community Connect, allowing hospitals to extend their Epic system and their Cirius system to community physicians and expand and strengthen those relationships. The Claim Status Manager integrates with Prebill Manager to produce ANSI 276/277 transactions, automatically providing claim status information. With nearly 35 years in the industry, Cirius has many large and complex medical centers that use PreBill UB04 Manager and the PreBill 1500 Manager for all of their billing. Cirius has established a strong reputation for substantially improving the financial performance and the credit ratings of the providers installing Prebill Manager. It is also used to implement and optimize billing operations when customers install a new EMR such as Epic or Cerner.

Cirius’ product design and configuration options allow their customers to effectively incorporate additional facilities as they acquire other provider entities. Given the M&As in healthcare, Cirius helps their customers handle additional business, with more claims and payments, without the need for additional staff. “Cirius has been a consistent vendor for decades, improving the financial performance of providers. We will evolve and continue offering the best revenue cycle systems available, and in the process, improve the relationships between providers and payers,” concludes Ehnen.