Providers are looking for new ways to save money
PROVIDERS are facing greater pressure to streamline their operations, according to Paul Pitcher, director of financial systems at KLAS. There is an ever-increasing focus on such areas as denials management, late billings, point-of-service collection and reduction of errors on the front end, where providers hope to squeeze out more revenue. Providers are looking to better manage their chargemasters and looking for new technologies to reduce full-time employees and provide workflow to aid in pinpointing revenue that is not easily identifiable. “There is a desire for hospitals to improve and fine-tune every point in the revenue cycle,” he said.
THREE TRENDS TO WATCH
Paul Pitcher, director of financial systems at KLAS, identified three trends impacting revenue cycle management:
1.REINFORCEMENT: Acquisitions of products by IT vendors to complete their revenue cycle management suite of tools will continue.
2. INVENTION: The industry is seeing a lot of energy in vendors coming out with newer products.
3. INTEGRATION: Providers are looking for integrated applications and systems and the elimination of bolt-on technologies.
VENDOR SHOWCASE
Accuro, a MedAssets company
Accuro Receivables Manager, MyMentor
Accuro Receivables Manager is a Web-based solution designed to decrease bad debt, accelerate cash flow and improve the overall accuracy of financial reporting. MyMentor offers tools to help collectors make informed decisions on the most effective approach to their accounts and provides performance feedback in relation to the organization’s financial goals.
Contact: Sales Support, 877.321.0500, solutions@accurohealth.com
athenahealth
athenaCollector
athenaCollector includes Web-based practice management software that simplifies every step of the process – patient registration, scheduling, eligibility verification, check-in, coding, referral management, check-out, appointment follow-up, collections, accounting and reporting.
Contact: Bob Gatewood, bgatewood@athenahealth.com
CareMedic Systems
Electronic Financial Record
The electronic Financial Record (eFR) is the solution to implementing your revenue cycle process redesign. The eFR extracts information from all pertinent host systems to create patient-centric, longitudinal financial records. The eFR governs the activity across your business environment moving information to the right people only when automation requires human intervention. Contact: Jose Miranda, sales analyst, 800.508.8494
Connance
Agency Manager
Agency Manager is designed specifically to address the complex business challenges associated with outsourced collections management in the healthcare industry and enables optimization of the entire collection management lifecycle through a single Web interface for all accounts placed with vendors. This advanced Web-based platform enables healthcare providers to automate the placement to and oversight of collection agencies working on self-pay patient accounts.
Contact: Tsipora Cohen, 781.577.5000, tcohen@connance.com
Eclipsys
Sunrise Access Management/Sunrise Patient Financials
A new module of Eclipsys’ Sunrise Access Manager and Sunrise Patient Financials solutions, the revenue cycle dashboard, is a fast and powerful analytic tool to support improved financial performance and business decisions that can be deployed quickly and cost-effectively.
Contact: Bradley Tinnermon, 404.847.5224, Bradley.Tinnermon@Eclipsys.com
Emdeon Business Services
Emdeon Assistant
Emdeon Assistant simplifies patient registration through real-time automation of patient eligibility and information verification tasks. Emdeon Assistant easily interfaces with most existing registration systems and channels search requests to Emdeon contracted carriers with responses generally returned in seconds.
Contact: 877.363.3666, instsales@emdeon.com
Epic Systems Corp.
Resolute Hospital Billing, Professional Billing
Resolute Hospital Billing coordinates inpatient and outpatient billing for hospitals. It helps staff streamline billing and collections, reduce denials and minimize AR days. Drawing information from the EpicCare clinical system, Resolute completes appropriate fields and submits claims in HIPAA-compliant formats.
Resolute Professional Billing helps reduce A/R days, allows paperless collections and streamlines data entry. Your billing office can track revenue from individual entities, divisions or markets. Medical necessity checks and charge/claims scrubbing routines help reduce denials and satisfy demanding payers.
Contact: 608.271.9000, Info@epicsystems.com
McKesson
Horizon Enterprise Revenue Management
Horizon Enterprise Revenue Management is a breakthrough solution designed to dramatically improve the economics of care by reinventing the way health systems manage revenue – streamlining patient access, connecting business partners and determining financial responsibility for constituents before and during care.
Contact: Jeff Shelton, 404.338.3200, jeff.shelton@mckesson.com
Medical Present Value (MPV)
MPV Phynance
MPV helps medical groups maximize the value of their payer contracts and improve revenue cycle efficiency through a comprehensive set of payer compliance tools and services designed to optimize contract performance, recover underpayments, negotiate better contracts and reduce patient write-offs.
Contact: Merideth Wilson, 512.430.0201, mwilson@mpv.com
MEDITECH
Revenue Cycle
MEDITECH’s Revenue Cycle product offers accounts receivable management features including: flexible bill generation, patient-friendly statements, automated reminders for proactive account follow up, A/R analysis reports, collector and denial management desktops, online bill pay, and electronic claim submission and remittance options.
Contact: Paul Berthiaume, 781.821.3000, ext. 5742, pberthiaume@meditech.com
Misys Healthcare Systems
Misys Payerpath
Misys Payerpath Claims Management is a complete revenue cycle management solution that provides an easy-to-use, secure method for electronically submitting insurance claims to payers quickly, accurately and cost effectively. The solution offers real-time error identification, online editing capabilities and easy integration with practice management systems.
Contact: 800.334.8534
Navicure
Navicure Claims Management
Navicure’s award-winning Web-based account receivables management solutions automate receivables processes, including patient eligibility verification; primary and secondary claims reimbursement; rejected and denied claims management; electronic remittance posting; claims and remittance reporting and analysis; and patient statement processing.
Contact: Matthew Halkos, 877.280.3334, sales@navicure.com
Zotec Partners
Electronic Billing Center (EBC)
EBC is where charges are created, payments are posted, images are scanned, appeal letters are generated and all charge follow-up activity occurs. Specialists interact seamlessly with tax ID numbers, patient profiles and service records and easily address patient needs.
Contact: 317.705.5050, sales@zotec.com
USER REVIEWS
“Navicure is always one step ahead with payer updates and issues, as well as having top-notch customer service and implementation teams.”
Stephanie Milanic, physician billing supervisor, Praxis Health Group
“The Eclipsys AM/PFM product has allowed Children’s Hospital to maintain excellent financial performance with the help of its robust revenue cycle management capabilities. Children’s is now implementing work quality monitors to help further the benefits of AM/PFM that were not part of our initial system implementation.”
Allana Cummings, vice president and CIO, Children’s Hospital in Omaha
“Using a Web-based service for our practice management system provides transparency across all parts of our practice, alleviating a lot of the administrative headaches, which ultimately allows us to spend more time with our patients.”
Lesson learned: “Initially, gathering all the information to put into athenahealth’s system created work on our end, but once we put the workflow processes in place it expedited and improved the way we saw our patients,”
Donna Masucci, RN, Dr. Peter Masucci PC
“Emdeon Assistant really helped us to automate our workflows and instantly retrieve critical patient registration information. Not only is this application easy to use, but it has also allowed us to become much more efficient within the patient registration process because it automatically populates our billing system with eligibility information.”
Carol Plato Nicosia, administrative director of corporate business services, Martin Memorial Health Systems
“Everything is easier with MPV; we no longer have to dig through pages of payer contracts to manually calculate what our payer reimbursements should be and we have the data to support claim appeals and negotiate new contracts with payers.”
Lesson learned: “Overall the implementation of MPV was smooth; however, in the beginning, we experienced a few challenges such as minor reporting glitches and validating that payer contract data was loaded correctly by MPV – especially modifiers.”
Herb Stanley, associate director of financial services, University Physicians, an academic faculty practice plan for the University of Missouri School of Medicine
“eFR is our insurance policy to protecting revenue and accelerating cash collections. We continue to experience a reduction in denials, accelerated cash collections, increased productivity, enhanced relationships with inter and intra departments and expedient outsource reconciliation processes. The ROI is guaranteed.”
Deborah Messina, director of business operations, Stamford Hospital
“Before, we would talk about reducing A/R days; and many of our staff just didn’t make the connection between their job and the bigger picture. Now, it’s real to them because they see the value of their contribution. Accuro Receivables Manager and MyMentor have helped create an entrepreneurial environment where employees take ownership and feel empowered by their success.”
Lesson learned: “There was a paradigm shift that needed to take place with both our management and patient representatives in moving away from measuring mere activity (number of accounts worked and phone calls made) to measuring actual results (cash collected and individual A/R days). By making this shift, we have seen greater job satisfaction and have surpassed all industry standard KPIs.”
Rick Thoresen, revenue cycle analyst, Regions Hospital
“Over the past three years, Zotec has greatly improved the efficiency of its data capture process, which has helped us to eliminate our auto-coding vendor and, in turn, has saved us more than $120,000 annually.”
Lesson learned: “Today’s newer integrated practice management systems are extremely robust. It is impossible to absorb all the capabilities that a Zotec type system has to offer in just one or two training sessions. We needed regular training sessions to truly get the most out of their EBC systems. I would recommend that any practice who implements a new practice management and or RIS system add a requirement to their service contract that includes regular scheduled training sessions at three, six, nine and 18 months post implementation.”
Jeff Fox, executive director of business development, Riverside Radiology Associates
“In my experience, going with Misys Payerpath has been a change for the better in my business office. Misys Payerpath is an exceptional product and it works very well to reduce AR.”
David Handy, CEO, Charleston Cancer Center
