Strategies for Revenue Cycle Success in the Healthcare Industry

Transcription

1 Strategies for Revenue Cycle Success in the Healthcare Industry Tips to Help Physician Practices Improve Revenue in Today s Challenging Healthcare Industry 2016 Etransmedia Technology, Inc 1

2 Copyright and Disclaimer The Strategies for Revenue Cycle Success in the Healthcare Industry whitepaper is published by Etransmedia. No part of this publication can be reproduced, copied, or transmitted in any form or by any means, or be stored in a retrieval system of any type, without obtaining prior written permission of Etransmedia. Application for permission to reproduce all or part of this white paper shall be made to Etransmedia 385 Jordan Road, Troy, NY Although the greatest care has been taken in the preparation and compilation of this white paper, no liability or responsibility of any kind, to an extent permitted by law, including responsibility for negligence is accepted by Etrasmedia, its employees, or affiliates. All information gathered and published herein is believed correct as of January, All corrections should be sent to Etransmedia for future editions. 2

3 Table of Contents Copyright and Disclaimer... 2 Table of Contents... 3 Executive Summary... 4 Introduction... 5 Industry Dynamics Affecting Healthcare Revenue Cycle... 5 Some Statistics That Highlight The Need For Revenue Cycle Management Best Practices to Improve Healthcare Revenue Cycle Efficiency Improve Efficiency and Productivity By Streamlining Processes Take Control Of The Reimbursement Process Evaluate Payor Contract Reconsider Your Patient Collection Practices Engage Patients and Encourage Their Involvement In The Process Devise a Denial Resolution Strategy Mine Your Data to Increase Volume and Revenue Establish KPIs to Monitor and Measure Performance...14 Outsourcing Revenue Cycle Management A Sound Business Decision?...15 Top 7 Reasons Healthcare Firms Outsource RCM...16 Conclusion...17 About Etransmedia...18 Contact Information

4 Executive Summary In recent years, the US healthcare industry has experienced significant changes in regulations which have led to changes in the way healthcare services are organized, delivered, and financed. Recent changes in laws and regulations, particularly the introduction of the Affordable Care Act (Obama Care), a transitioning coding system, and increasing pressure on healthcare providers to adopt cost-containment strategies while ensuring and improving the quality of healthcare services have revolutionized the way healthcare organizations operate today. The transition from fee-for-service to value-based payment models, declining hospital admission rates, PQRS penalties, and escalating healthcare costs, all have contributed to the shrinking revenue figures of healthcare providers. With more than 20 percent of hospitals operating in the red 1, it s high time healthcare providers look for ways that can help them improve their organization s revenue for transaction figure and drive it towards sustainability. The technological revolution and regulatory changes have also affected private practices and ambulatory centers. In order to cope with the shrinking profit margins, physicians are moving rapidly from private practice to employed models through vertical and horizontal consolidation. 2 Today, to compete in a healthcare environment that demands clinical and operational efficiency, healthcare providers need to ensure that their financial operations are running efficiently. In an environment where financial pressures are escalating to record levels and reimbursement rates are declining, only a well-managed revenue cycle can help healthcare providers minimize the time spent on administrative duties, ensure them maximum revenue and unobstructed cash flow, and provide them time to focus on their core function provision of healthcare services. This whitepaper provides an overview of the recent healthcare industry trends that are affecting practices bottom-lines as well as statistics that reflect how escalating financial pressures have shifted the focus of healthcare providers from clinical activities to administrative tasks. It also contains a quick revenue cycle self-assessment to help physicians determine whether their practice is in need of effective revenue cycle management. A majority of this whitepaper is comprised of 7 tips which healthcare providers can use to improve the revenue generating capacity of their practices. From workflow analysis, evaluation of payor contract, and denial resolution to improving patient engagement level and measuring practice s financial health, this whitepaper provides comprehensive guidelines on optimizing the entire revenue cycle. The document explains how the changing healthcare industry landscape has led to a generation of newer business opportunities. It explains the reasons behind the increasing trend of outsourcing the revenue cycle management (RCM) function among healthcare organizations. This whitepaper highlights the benefits of outsourcing RCM with concrete statistics reflecting improvement in the performance of healthcare firms that have outsourced their RCM function. 1 Revenue Cycle Management, Outsourcing Industry Report, Kaulkin Ginsberg Health Care Providers Outlook United States, Mitch Morris, Deloitte 4

5 Introduction In recent years, the US healthcare system has experienced significant changes, most of which have been fueled by the Affordable Care Act, also known as Obama Care. Coupled with a coding system transition, these regulatory changes have revolutionized the way the US healthcare system operates today and have compelled the healthcare providers to provide maximum value to their patients while lowering the costs. Industry Dynamics Affecting Healthcare Revenue Cycle With over one-third of all healthcare organizations operating on negative margins 3, the need for an effective and efficient revenue cycle management system has been realized by a large number of healthcare organizations. The total market size of outsourced revenue cycle management (RCM) services has already reached $5 billion, and it is estimated that escalating financial pressures will further expand the market, which was expected to experience a growth rate of 14.6 percent in Rising healthcare delivery costs, lowering reimbursement rates, and shrinking profit margins have escalated financial pressures and have driven many private practices and hospitals towards an unsustainable financial position. In addition to this, various other factors, which have contributed to the financial challenges being faced by healthcare organizations today, are listed below. Increased Patient Financial Responsibility In recent years, financial responsibility has been shifted to consumers. This has resulted in increased patient liability and bad debt, and as a result, healthcare organizations are facing unprecedented financial pressures. Physician practices and clinics have become retail organizations that must provide their patients access to payment capabilities at the point of service delivery. The shifted financial responsibility has exposed healthcare providers to a number of challenges which must be addressed in order to optimize patient payment process. Hospitals and clinics must address the problems faced by their patients, such as lack of options for payment plans, confusing financial statements and billing policies, and poor timings of bills. 5 Transition to Value-Based Care The implementation of the Affordable Care Act in 2010 resulted in the much-awaited transition from fee-for-service model to value-based payment model. The value-based payment model, which was introduced with the intent to improve the quality of healthcare services being provided to the Medicare beneficiaries, resulted in transformation of healthcare delivery and payment models. Today, healthcare providers are paid based on the value of care they deliver instead of being paid for the number of patients visits or tests ordered. 3 The Fragile State of Hospital Finances, American Hospital Association 4 Revenue Cycle Management, Outsourcing Industry Report, Kaulkin Ginsberg 5 The Next Wave of Change for US Health Care Payments, Thomas Pellathy and Shubham Singhal, McKinsey & Company 5

6 This transition to value-based care reimbursement model is one of the greatest financial challenges faced by healthcare organizations today. They are not only required to reconcile the new payment model in conventional fee-for-service environment but also need to use sophisticated analytics to measure their financial performance and quality metrics. To make a successful transition to valuebased reimbursement model, healthcare providers need to: Understand the cost structure Develop a system to automatically track quality measures Streamline operations and reduce waste These challenges may seem insurmountable, but with expert revenue cycle management, healthcare providers can meet these challenges and adopt a sustainable financial position. Regulatory Challenges Regulations related to ICD-10, meaningful use, ACA, transparency, and 340B have added to the complexity of the healthcare regulatory environment. Also, health information breaches, which cost over $5.6 billion to the healthcare industry annually 6, have escalated financial burdens. As a result, healthcare providers are forced to reassess their compliance processes and invest in new technologies to meet the regulatory requirements. Ambulatory systems and physicians practices, which lack the infrastructure and capital required to fulfill the regulatory requirements, are looking for innovative ways to ease the financial burden, such as consolidation and outsourcing. Finally, Physician Quality Rating System (PQRS), which once provided incentives for reporting on quality measures, is now penalizing physicians who do not submit quality data. This has significantly affected the profit margins of physician practices Health Care Providers Outlook United States, Mitch Morris, Deloitte 6

7 Statistics that Highlight the Need for RCM Increasing regulatory and financial pressures have significantly impacted the bottom-line of physician practices and other healthcare organizations. Now, not only are healthcare providers compelled to spend more time on administrative tasks, they are also combating declining reimbursement and increasing denial rates, which are cutting into their profits. The answer to all these financial and regulatory challenges faced by healthcare organizations today is an effective and efficient revenue cycle management (RCM) system. The need for effective RCM systems is also highlighted by some interesting statistics given below. The average US doctor spends one-sixth or 16.6 percent of his or her working hours on administrative tasks. 7 There has been a 64 percent increase in operating expenses of physician-owned multispecialty practices from 2001 to About 65 percent of physicians believe that declining reimbursement rates are cutting into their profits. About 25 to 30 percent of lost medical practice income is due to improper billing. ICD-10, the new system for classifying disease, which has been imposed on practicing physicians on October 1, 2015, is likely to cause a 100 to 200 percent increase in denial rates. Physician practices spend $68,274 per physician per year interacting with health plans. More than 75 percent of physicians feel that the administrative burden has increased significantly in the past two years. 8 7 Electronic health records increase doctors bureaucratic burden, PNHP 8 Findings Briefs, Changes in Health Care Financing & Organization (HCFO), March

8 Best Practices to Improve Revenue Cycle Efficiency Evolving reimbursement and care delivery models and regulatory pressures have increased the administrative responsibilities of physicians. As a result, physicians have less time to spend on direct patient care. With an effective revenue cycle management (RCM) system in place, physicianowned healthcare systems can streamline the processes which are critical to the organization s financial health. There are some best practices that healthcare providers can adopt to improve their revenue cycle s efficiency. These best practices are aimed at improving the bottom-line of physician practices by improving their efficiency, patient engagement rates, collection processes, and denial resolution practices. 1. Improve Efficiency and Productivity By Streamlining Processes Time is money for physician-owned healthcare systems. In order to maximize revenue while ensuring delivery of quality healthcare services to patients, healthcare providers should aim to service as many customers as possible by improving the efficiency of processes. Conduct Workflow Analysis In order to gain better control of the revenue cycle of an organization, management must conduct a workflow analysis and identify the revenue bottlenecks, map every process involved in the delivery of healthcare service to the patients and identify the people responsible to perform specific tasks. This includes all the processes related to a patient s visit to a practice, including the billing cycle and the clinical processes. Once processes have been mapped, an in-depth analysis should be carried out to identify potential improvement areas. Determine if acquisition of a new technology solution can help improve the efficiency of a process. Conduct a risk-benefit analysis to determine the potential return on a particular investment. Quick Revenue Cycle Self- Assessment 7 Questions to Determine If You re Effectively Managing Your Revenue Cycle 1. Have you analyzed your patient mix and developed strategies to minimize no-shows and wastage of resources? 2. Have you developed a payor matrix and do you know the reimbursements you re contracted to receive? 3. Does your practice suffer from low collection rates? Have you introduced new, innovative payment mechanisms to combat this problem? 4. Do you know the top reasons for insurance denials and how to prevent and correct them? 5. What are your patient engagement and satisfaction rates? Do your patients find it easy to book an appointment at your practice? 6. Have you set KPIs to monitor your performance? 7. Are you making an effective use of your practice and patients data? 8

9 Analyze Your Patient Mix It s important to understand that running a practice is just like running any other service business, in fact it is more complicated. The management should identify the potential consumers and position the services accordingly. Analyze your patient mix and determine if the majority of your customers are capitated patients or fee-for-service (FFS) patients. Once you have conducted an analysis of your potential patients, strategically fill your schedule in such a way that you don t lose the revenue coming from FFS patients. Categorize Your Visits Different patients visit clinics and hospitals for different needs, and as a result, healthcare providers are required to spend different amounts of time to address their healthcare issues. For example, an established patient visiting your clinic for a routine checkup will require less time and attention than a patient coming with an acute healthcare problem. When developing the schedule for your practice, it is important that you prioritize your patients based on the acuity of their healthcare needs, the time required to serve them, and the profit generated from each visit. For example, you may want to schedule a patient visiting your clinic for the first time during later hours of the day because new patient visits usually take longer. On the other hand, you may want to prioritize an FFS patient over a capitated patient because they may visit some other clinic if their healthcare issues are not addressed at the right time by your practice. Consider Double Booking In an era of escalating healthcare costs and shrinking profit margins, resource optimization has become essential for achieving financial sustainability. However, the problem of patient no-shows (patients who do not arrive for a scheduled appointment) has become a major hassle for healthcare organizations looking for ways to improve their efficiency and productivity and reducing healthcare costs. The no-show rates for healthcare organizations vary greatly, ranging from as little as 3 percent to as high as 80 percent. 9 One way to optimize resource utilization in healthcare settings is to conduct a patient mix analysis and identify the patients who have a history of cancelling the appointment. For such patients, practices may consider double-booking in order to avoid the productivity loss caused by appointment cancellations or no-shows. Introduce No-Show Fee The no-show rates for Medicaid patients can be as high as 33 percent, which means that one in every three patients doesn t show up for a scheduled appointment. The high no-show rates result in reduced provider productivity, reduced practice efficiency, and wastage of scare healthcare resources. One effective way to prevent escalation of your practice s no-show rate is to develop a no-show policy. The policy should address the following areas: Acceptable reasons for no-shows Notice time for appointment cancellation No-show or appointment cancellation fees 9 An appointment overbooking model to improve client access and provider productivity, Linda R. LaGanga and Stephen R. Lawrence 9

10 2. Take Control Of The Reimbursement Process Evaluate Payor Contract Good revenue cycle management is critical to a practice s success and it starts with a signed payor contract. However, in the increasingly complex healthcare environment, it may become difficult for healthcare organizations to verify that their payors are complying with the contract terms. At times, payors may also amend reimbursement terms which may cost healthcare providers lost revenue. It is important that healthcare organizations have easy access to a complete and accurate payor matrix. The matrix should include key data for each payor, including their contact information, current reimbursement terms, and key provisions in the written agreement. This matrix provides you key information and helps you ensure that you re getting paid for what you deserve. In order to have an upperhand during the renegotiation process, set reminders for review. For example, if your payor contract is set to expire on June 30th, you may want to review the terms and start the renegotiation process in January so that you have enough time to negotiate favorable reimbursement terms. 3. Reconsider Your Patient Collection Practices The recent shift in financial responsibility to patients means healthcare providers should prepare themselves to embrace consumerism and establish systems that can manage the higher levels of out-of-pocket healthcare spending by patients. Healthcare organizations need to overhaul their patient collection processes in order to offer better transparency to patients and ensure uninterrupted cash flow. Do Your Homework In order to improve the revenue-generating capacity of your practice, you must conduct an analysis of the financial capability of your patients. Gather information about your patients insurance coverage, financial responsibility, and benefits eligibility before they arrive at your office. Insurance Coverage Determine what co-payments and deductibles are due. Also ensure that the patient s insurance plan is active. Benefits Eligibility Determine if the patient s healthcare plan provides coverage for the services they want to acquire at your office. Financial Responsibility Have an effective system in place to determine the patient s balance and due. 10

11 Get Payments Up Front, at Check-In Collecting payments at the time of service is probably the most effective way to increase a practice s cash flow. Up-front payments at the time of service delivery not only helps an organization improve its cash flow but also helps them avoid the cost and time spent on collecting accounts receivables. In order to develop a point-of-service collection system, healthcare providers need to collect complete information regarding a patient financial responsibility, including co-insurance, co-payment, and deductibles, and use this information to provide accurate estimates to the patients. When complete financial information is unavailable, the payment collection process should be shifted to the check-out stage. Make It Easy to Pay In an increasingly retail-like healthcare environment, patients are using multiple channels to make payments for the healthcare services they receive at a clinic or hospital. It is important to conduct an analysis of the payment behaviors of the patients visiting your practice and determine the payment options most commonly used by patients. Wherever possible, a practice should offer all possible payment options, including cash, checks, debit cards, and credit cards. With over 90 percent of the consumers preferring online payments, it is important for practices to offer online and mobile payment solutions. These payment options not only offer better efficiency by automating the payment process, but also offer greater transparency and, hence, are more trusted by the consumer. Figure 1 provides an overview of the different payment options used by patients to make payments at the time of service delivery. Train and Incentivize Your Staff If you have developed a new collection policy, make sure that it is communicated to the staff who will be involved in the collection process. Train your staff about how to use the system Figure 1 - What Payment Modes Patients are Using to Pay for Services at the Time of Delivery and the patient s financial information to determine their eligibility. Use role-play and other activities to help them learn how to ask for payments or how to explain payment plans to the patients. Once you have trained the staff, monitor their performance and their monthly collections to evaluate the effectiveness of the training process. Using financial incentives to motivate your collection staff will not only boost the morale of your team, but will also contribute to your practice s bottom-line. 11

12 4. Engage Patients and Encourage Their Involvement In The Process Today, patients have been obligated to assume the financial responsibility for their healthcare needs, and as a result, they have become more empowered in making decisions about where to receive healthcare services. This shift of financial responsibility has forced healthcare providers to look for innovative ways that can help them improve their patient engagement and satisfaction rates. Allow Patients to Schedule Online Today s healthcare consumer demands a new healthcare experience, where they can connect with their healthcare providers in a secure manner and share and utilize healthcare information. Developing a patient portal where patients can make requests for medical advice, schedule appointments, submit prescription renewal requests, and access test results, can improve patient engagement and satisfaction drastically. Send Reminders Reminding patients of their appointments has several benefits. It improves patient engagement rate and helps the healthcare providers establish their identity as a patient-centric healthcare service. In addition to this, reminders can help practices reduce their no-show rates and improve their resource utilization, which consequently reduces the healthcare costs and improves revenue. Make Online Bill Payment Possible Making small process changes to accommodate patient preferences can add a lot to a practice s revenue. With about 22% of all mobile phone owners using the device to make payments 10, it s high time healthcare providers make online bill payment possible for patients. By offering convenient online payment options, healthcare providers can encourage their patients to pay bills on time without the need of visiting the office. 5. Devise a Denial Resolution Strategy The way a healthcare organization manages denials has a major impact on its revenue and sustainability. Failing to adequately manage denials from insurers results in lost revenue and can impact a practice s ability to sustain financial pressures in today s challenging healthcare environment. In order to effectively manage denials and ensure the practice s financial health, healthcare providers should devise a denial resolution strategy and develop best practices to handle denials. Outline the Top Reasons The first step in denial management is to identify the reason for denial. Even the best-performing practices experience a denial rate 11, but their ability to identify and eliminate the root-cause enables them to make good profits even in financially-challenging situations. 10 Consumers and Mobile Financial Services 2015, Board of Governors of the Federal Reserve System 11 MGMA Performance and Practices of Successful Medical Groups, 2012 Report 12

13 When claims are returned unpaid, the insurers indicate a reason for denial. However, deciphering the code used by insurers can be difficult at times. For example, the code CARC 16 is used when claim lacks information which is needed for adjudication. The statement doesn t highlight the information which is missing. This makes the process of identifying the reason for denial difficult for healthcare providers and, as a result, impacts their practice s revenue. Establish a Process for Following-Up on Denials Once you have identified the reason for denial, start working on its resolution immediately. Most insurers impose time limits when it comes to resubmitting the claim; therefore, begin working on the resolution and gather all the information you need within 24 hours. Review insurer s comments about the denial, go through the internal documents and insurer s policies, and if required, contact the patient. Develop Templates For effective management of denials, your staff needs immediate access to denial resolution tools, such as templates for specific appeal letters and tracking of denials and payor s rules and guidelines. To save time and to accelerate the denial resolution process, make sure that your staff has access to all these tools and resources. 6. Mine Your Data to Increase Volume and Revenue Data mining holds great potential for healthcare organizations, particularly physician practices and offices that are operating on narrow profit margins. These healthcare organizations can use data to identify potential revenue holes, reasons for denials, and patterns of resource utilization. The information can then be used to improve the provider s revenue cycle management system. Identify Revenue Holes Using data available through medical billing software, healthcare providers can identify the most common reasons for denials and work on them to improve their denials rates. In addition to this, the effectiveness of account receivable collection efforts can also be analyzed through this information. Management can then work on the processes to improve the efficiency of their RCM system. Dig Into Your Data to Identify Repeat Customers The medical billing software and practice management system of a physician s office contains valuable information, which can be exploited to increase patient volume and practice s revenue. Using this information you can identify the patients who are due for follow-up appointments and reach out to them. Examples include patients with chronic healthcare conditions, such as diabetes, heart failure, etc., or pregnant women who may be due for routine checkups or children who may need immunization. 13

14 7. Establish KPIs to Monitor and Measure Performance What gets measured gets managed 12. This saying is especially true when it comes to revenue cycle management, particularly in the healthcare industry. A practice s performance and revenue improvement starts with an understanding and monitoring of key performance indicators (KPIs). A report published by the Healthcare Financial Management Association highlights the need of frequently monitoring advanced KPIs for improving the performance of revenue cycles 13. The traditional and advanced KPIs provide a basis for the assessment of the effectiveness of revenue cycle management against industry benchmarks and/or historical performance. Depending on the strategic objectives, a healthcare provider may choose different traditional and advanced metrics to monitor and improve the performance of an organization. Traditional KPIs, which are also known as baseline KPIs, provide retrospective data and help an organization respond to changes. On the other hand, advanced KPIs aim at identifying the root cause of an issue and help the organization identify potential improvement areas and make process improvements. Key Baseline KPIs To Track Gross and net receivables over a specified period Claim rejection rates Claim denial rates Net collection rates Charge lags Days receivables outstanding Key Advanced KPIs to Track Patient wait times Underpayment reviews Number of referrals Denial appeal rate Denial appeal success rate Self-pay collections Incomplete or missing charges Coding turnaround time Strategies for a High-Performance Revenue Cycle, A Report from the Patient Friendly Billing Project, HFMA 14

15 Develop a Dashboard of KPIs and Benchmarks In order to have a better view of your practice s performance, develop a performance dashboard. This dashboard encapsulates performance metrics or KPIs in the form of layered visual information. The visual representation of information helps users measure, monitor, and manage the key metrics and identify potential problems and opportunities. In addition to this, a KPI dashboard, which allows comparisons with industry norms, helps users benchmark the performance data with industry standards. Traditional KPIs Retrospective View + Advanced KPIs Root cause analysis Process Improvements Improved Revenue Cycle Performance Figure 2 How Traditional & Advanced KPIs Lead To Revenue Cycle Improvement Establish Goals & Measure Performance When setting KPIs, it is extremely important to make sure that the KPIs are aligned with the organization s strategic objectives. For example, if a practice aims to serve 10 percent more patients, it should measure KPIs that are related to patient volumes, such as patient wait times, number of visits per day, no-show ratio, etc. 15

16 Outsourcing Revenue Cycle Management A Sound Business Decision? In today s financially challenging healthcare environment, what can healthcare providers do to contain costs and improve revenues? The answer to this question lies in outsourcing RCM function. With healthcare professionals facing challenges adopting new payment models, reporting quality data and adhering to rules and regulations, outsourcing the management of revenue cycle can help them focus on their core task providing healthcare services to their patients. In addition to this, the recent shift in financial responsibility has caused organizations to face new payment collection challenges. The shift has not only increased the administrative responsibility of healthcare providers but has also left a negative impact on their practice s bottom-line. Outsourcing RCM can be an effective way to improve collection processes, improve cash flow, and decrease healthcare costs. Partnering with a trusted medical billing partner is also proven to help organizations improve their financial health. Organizations that outsourced their billing function have experienced improvement in the following key performance metrics. 73 percent of organizations realized a reduction in A/R days and achieved higher collections. 59 percent observed reduction in the number of denied claims. 59 percent of firms reported access to better reporting and analytical tools. Top 7 Reasons Healthcare Firms Outsource RCM A survey conducted by PricewaterhouseCoopers identifies that organizations may have different strategic objectives for outsourcing the revenue cycle management (RCM) function 14. Top 7 reasons firms outsource RCM include: 1. Lower costs 76 percent 2. Gain access to talent 70 percent 3. Outsource activities that others can do better 63 percent 4. Increase business model flexibility 56 percent 5. Improving customer relationships 42 percent 6. Offering new services to the customers/market segment expansion 37 percent 7. Geographic expansion 33 percent 14 Outsourcing comes of age: The rise of collaborative partnering, PricewaterhouseCoopers 16

17 Conclusion Recent health regulations, changing customers preferences, and increasing competition have made it essential for the managers of healthcare organizations and practice owners to look for innovative ways to improve their customer satisfaction, engagement rates and revenues. The changing landscape has also shifted the focus of physicians from their core responsibility, providing healthcare services, to administrative tasks. This not only has led to poor patient satisfaction and compromised quality and delivery of healthcare services but has also impacted the bottom-line of healthcare organizations. In today s challenging circumstances, outsourcing the administrative functions to third-parties seem to be a reasonable solution. This will not only help physicians focus on their core task by freeing up their time and resources but will also improve their practice s revenue. Practices and hospitals that have outsourced their revenue cycle management function to third-party experts have experienced significant improvement in their collection rates, denial resolution efficiency, patient satisfaction rates, and revenue. 17

18 About Etransmedia Working since 2000 to help physicians avoid the hassle and headache associated with operating of their practice, Etransmedia medical billing services and health IT solutions to physician offices and other healthcare organizations. Using cutting-edge technology and extensive experience of managing revenue cycles of healthcare organizations, Etransmedia offers comprehensive RCM services which are proven to deliver maximum ROI to the physicians. Contact Information: Phone: rcmsales@etransmedia.com NORTHEAST 385 Jordan Road Troy, NY Locations: METRO NEW YORK 12 Cambridge Drive Trumbull, CT PENNSYLVANIA 335 Morganza Road Canonsburg, PA GREATER BOSTON 3 Allied Drive Dedham, MA OHIO & MIDWEST 1111 Schrock Road Columbus, OH SOUTHEAST S. Commerce Blvd. Charlotte, NC SOUTHERN CALIFORNIA Formerly DoctorsXL 3215 W. Charleston Blvd Las Vegas, NV SOUTHWEST North Black Canyon Phoenix, AZ PACIFIC NORTHWEST Formerly DoctorsXL Professional Circle Reno, NV