RCM Rules Engine Validations


Axxess RCM is an intuitive clearinghouse solution that is fully integrated with Axxess Palliative Care. Leveraging this integration, Axxess Palliative Care automatically generates claims and checks them for terminal errors.


As users verify claims in Axxess Palliative Care, the system automatically runs them through Axxess RCM clearinghouse validations using Axxess intelligence™. This functionality helps organizations ensure all claims meet payer requirements before submission.


To verify a claim, navigate to the Claims screen under the Billing tab and select Verify next to the desired claim.


Billing tab ➜ Claims ➜ Verify


When Verify is selected, the claim will open for review. Verify that all the information in the claim is accurate and click the green Verify button at the bottom of the claim. When this button is selected, the system will check for missing information and unmet clearinghouse requirements. Error messages at the top of the screen will alert you to these errors.


Once all errors are addressed, the claim can be submitted.


Claims with errors will appear on the Claims screen with a badge identifying the number of errors in the claim. To view the errors, hover over or click the error badge.


To submit a claim, click Submit under Actions or select multiple verified claims and click Submit Selected to submit in bulk.