Improving Bottom-Line Results for Medical Centers
Managing the revenue cycle for any healthcare organization is a complex undertaking. However, as Medical Centers move to acquire and/or affiliate with strategic physician practices the operational challenges of integrating those practices with an existing patient services department can present unique challenges, such as:
What are the existing internal controls and revenue cycle activities of the multiple small provider practices?
Does each practice possess the required expertise and knowledge to accurately and compliantly code, bill, audit and collect for physician encounters?
Are you prepared to manage the information technology requirements to automate revenue cycle processes and interfaces between each practices and your existing Medical Center systems?
We routinely help our clients by:
Providing credential expertise to produce up-to-date information, monitor compliance, and minimize lost revenue - regardless of payer.
Improving data quality related to quality of care, risk management, and case management across the continuum of care.
Auditing the completion of medical records to ensure that any information gaps which may negatively affect revenue and accreditation standards are addresses in a timely manner.
Providing ad-hoc insight for physicians, physician extenders, and all ancillary personnel regarding reimbursement scope of services, coverage determinations, regulatory impacts, and organizational policies.
Developing customized training programs that address the specific needs and issues being experienced by a client.
Maintaining automated workflows and a sophisticated technology architecture, including a vast data repository to provide up-to-date information regarding payments, denials, and coverage trends for patients and third-party payers.
Negotiating third-party payer contracts based upon comprehensive charge, payment, denials and pending claim information housed in our data repository.