Industry Overview

  • An increase in revenue opportunities
  • An acceleration in rate of collections
  • Shorter revenue cycles
  • An overall achievement in significant cost savings

Challenges faced by practices

  • Incomplete, inaccurate, or "dirty" claims account for more than one in four submitted by physician offices
  • Major reasons of revenue losses in billing
    • Insurance Eligibility
    • Denials in Electronic Data Interchange
    • Inefficient or no follow up of claims filed
    • Unauthorized write offs by staff
    • Improper and late processing of claims denied by payers
    • Inefficient patient collection system
  • Over 20 billion dollars are wasted annually in the processing of flawed claims

Problems faced by health care service providers

  • High staff turnover
  • High training costs to meet compliance standards
  • Legacy, ineffectual and complex business processes
  • Cash flow variations due to errors, long turnaround times and quality
  • Time restraints for Management functions

Case Study

Case Study/Analysis – Summary

  • The Practice was able to increase the billing steadily for the past three years but was unable to increase the revenue at the same rate
  • Data analysis points to a weak collection system in place
  • Significant amounts have been adjusted as un-collectible or bad-debts
  • Aggressive follow-ups need to be in place to recover from insurance and patients
  • High outstanding from Medicare suggests that billing may not be properly coded or billed or deductibles are not collected
  • The ROI tool suggests high savings if the billing is optimized and professionally managed

Increase in Overall Revenue 5%-10%+

  • Elimination of lost Charges
  • Increase patient co-pay collection
  • Clear identification of appointments that need to be rescheduled
  • Immediate identification of outstanding patient balances
  • Maximize revenue through correct coding initiatives

Benefits

  • Quick Installation - saves time and reduces costs dramatically by offering installation in less than half the time required by competitive services, migration of patient and scheduling data from previous systems, and comprehensive on-site training.
  • Anytime, anywhere access to patient information – Essential to your practice’s success is the ability to access and manage patient information anytime and anywhere you need it. This completely web-based application provides a secure link to your schedule, billing and accounting detail reports, enabling you to manage the patient experience at all times.
  • Offloaded claim and statement processing – Release your practice from the strains of complete, accurate, and speedy statement mailing and claims processing. We help you to expedite the receipt of funds by automatically checking diagnosis codes, maintaining HIPAA compliancy, and verifying clean claim submissions. We also lift the burden of statement mailing and printing paper claims from your office staff.
  • Comprehensive reporting – Understand and manage the financial health and efficiency of your practice with extensive reporting. Focus in on specific segments of your practice to identify hidden opportunities or potential problems with flexible, user-defined analysis.
  • Accounting and data management – You are confident in the treatment you provide your patients. Be certain your practice is being equally well cared for. We seamlessly perform end-of-day and end-of-month processing and invoice aging so you don’t have to delay practice operations during closing. And the advanced technology is constantly updated, instantly backed up and immediately archived without pressing a button.