Revenue Cycle Management Optimized

Transcription

1 rreturnsttopbooth2014final.indd 1 6/13/2014 9:32:34 AM Revenue Cycle Management Optimized Powerful technology combined with expert knowledge and resources Innovative Revenue Cycle Management brought to you by the home health and hospice industry s foremost experts in software, outsourced services and consulting. Billing Services Coding Services OASIS Review Revenue Cycle Management Optimized Premier Returns combines powerful technology with expert knowledge and resources to create the most comprehensive Revenue Cycle Management (RCM) product available to home care and hospice providers. Premier Returns offers agencies competitively priced outsourced billing and coding operations and consulting, as well as consultation and support for OASIS review by the top consulting and top RCM service provider in the home care and hospice industry Simione Healthcare Consultants and HEALTHCAREfirst. Unparalleled Insight Audits, take-backs, compliance threats home health and hospice agencies face a number of risks in their business operations. The lack of insight about your revenue can make the difference between your success and failure. Premier Returns offers outsourced services paired with the technology and expert knowledge needed to not just get back on track, but also to succeed. Complicated Billing Made Easier Billing private insurance or commercial payers requires a great deal of preparation and organization. Many organizations decide to work with commercial payers and then suddenly find themselves in over their heads. Premier Returns alleviates the complications involved in private insurance billing, providing you with regular insight into your billing practices. OUTSOURCED SERVICES n Billing Services n Coding Services n OASIS Review Faster, More Accurate Payments A steady, positive cash flow is essential to business success. Accurate coding, proper billing and precise documentation are all indispensable when it comes to achieving financial success. Premier Returns will help to ensure that you are paid for the services you provide, and offer analytics and expertise to guide you along the way.

2 B i l l i n g S e rv i c e s C o d i n g S e rv i c e s O A S I S R e v i e w Premier Returns helps home health and hospice agencies successfully manage complex processes such as commercial billing, coding overflow, billing recovery and document review. PremierReturnsTTopBooth2014final.indd 1 Expert Billing Services Executive Management Reports Agency Summary Analysis Premier Returns assists providers nationwide in reducing costs and accelerating reimbursement through a complete billing services program. As the industry s only provider of billing services that includes Web-based analysis, reporting integration and consulting, Premier Returns will not only bring the benefit of pain-free billing, but also the knowledge needed to make better business decisions, all at a competitive price. Home Health, Inc. Agency Summary Analysis Total Revenue and Expenses (in thousands) Total Revenue Direct Costs Overall Gross Margin Home Health Hospice Other Operating Copyright 2014 Simione Healthcare Consultants, LLC Premier Returns billing experts specialize in the home health and hospice industry. They are experienced in a wide variety of payer processes, and are equipped with the knowledge to quickly and properly submit claims. As a result, you will see fewer billing errors and improved cash flow. Indirect Costs Revenue by Service Line (in thousands) Overall Net Margin Other Non Operating Provider # d Total Days Sales Outstanding 1 of 10 Certified Coding Services Now more than ever, home health and hospice organizations must submit accurate claims with proper diagnosis codes. Inaccurate claims can cost your business timely reimbursements and drain administrative time. Premier Returns outsourced coding services can improve coding accuracy, turnaround time and reimbursement at a competitive price. Premier Returns certified coding experts are continuously trained on the latest regulations, including ICD-10. Our experts return coding events by the next business day, resulting in shorter reimbursement cycles and improved cash flow. OASIS Quality Review Premier Returns identifies potential inconsistencies in OASIS and offers solutions on rectifying problems. Our certified OASIS review experts review the full chart, including physician orders, care plans/visit frequencies and clinical assessments. Our certified OASIS review experts will assess documentation and care plans thoroughly for consistency and make recommendations based on the clinical documentation. Review is completed by the end of the next business day. About Premier Returns sales@premier-returns.com Simione Healthcare Consultants and HEALTHCAREfirst have partnered together to create Premier Returns, offering Revenue Cycle Management services never before seen in home health and hospice. Backed by more than 60 years of collective industry experience, Premier Returns combines powerful technology and superior outsourced services with expert consultation and advice.

3 Revenue Cycle Expert Billing Management Services Optimized Powerful technology combined with expert knowledge and resources Reduce costs and accelerate reimbursement withspremier Billing Services Coding e rvi c e s Returns OA S I S Re vi e woutsourced billing services. Home Health and Hospice Billing Managed By Experts Simione Healthcare Consultants and HEALTHCAREfirst have partnered together to create Premier Returns, offering Revenue Cycle Management services never before seen in home health and hospice. Backed by more than 60 years of collective industry experience, Premier Returns combines powerful technology and superior outsourced services with expert consultation and advice. ReturnsTTopBooth2014final.indd 1 6/13/2014 9:32:34 AM Premier Returns helps home health and hospice providers nationwide reduce costs and accelerate reimbursement through our comprehensive billing services program. As the industry s only provider of billing services with Web-based analysis technology, reporting integration and consulting, Premier Returns will not only enable pain-free billing, but also provide the knowledge and advice needed to make better business decisions, all at a competitive price. COST-EFFECTIVE, TROUBLE-FREE BILLING The outsourced billing process is straightforward and trouble-free. We batch and submit claims to Medicare, Medicaid or private payer as soon as they are ready for submission. At this point, our billing experts go into collection mode to aggressively follow up, resolve errors, resubmit claims and get them paid. OUTSOURCED BILLING n Reduce costs of complicated billing n Protect your revenue n Accelerate cash flow

4 B i l l i n g S e rv i c e s C o d i n g S e rv i c e s O A S I S R e v i e w Designed to make your operations more efficient, Premier Returns outsourced billing services help reduce costs while accelerating your cash flow. PremierReturnsTTopBooth2014final.indd 1 Medicare and Private Insurance Billing Home Health Billing Analysis Premier Returns billing experts specialize in the home health and hospice industry. They are skilled in a wide variety of payer processes, including private insurance, and are equipped with the expertise to quickly and properly submit claims. As a result, you will see fewer billing errors and improved cash flow. Home Health, Inc. Home Health Direct Cost Analysis Distribution of Total Direct Costs Distribution of Total Direct Costs by Discipline RN LPN PT PTA OT OTA Billing Status Evaluation & Review ST MS W HHA Distribution of Cost by Discipline Skilled Nursing Physical Therapy Salary Taxes and Benefits Copyright 2014 Simione Healthcare Consultants, LLC Contract Transportation Medical Supplies Provider # d Revenue by Payment Status 2 of 18 Before we begin to manage your billing process, a Premier Returns consultant will provide an initial check of your financial health to determine how your business is performing. Additionally, we will meet with you on a regular basis to discuss your current financial status, and offer suggestions on how you can improve. Billing and ar Recovery Managing lost claims and aged accounts, while continuing to manage current billing and AR, is a difficult balance. Premier Returns billing/ar recovery service specializes in resolving unpaid claims so that you are properly compensated for your services. Analytic Technology Premier Returns provides comprehensive analytic technology that will allow you to see your business in a whole new light. This Web-based technology provides unsurpassed insight into your financial health, including the identification of hidden trends in revenue performance, lost revenue opportunities, clean claim rate, general ledger data, benchmarking, payer-specific analysis and much more. About Premier Returns Premier Returns is a joint Revenue Cycle Management solution developed for home health and hospice organizations by Simione Healthcare Consultants and HEALTHCAREfirst. We saw a need in the marketplace for comprehensive revenue cycle management, as many agencies struggle with timeliness, cash flow issues, regulatory requirements, and lost income, among the growing priorities of running a home care or hospice organization. Together we have all of the resources and expertise to solve these issues, relieving some of the pressure of revenue cycle management to help agencies concentrate on patient care sales@premier-returns.com

5 rreturnsttopbooth2014final.indd 1 6/13/2014 9:32:34 AM Revenue Cycle Certified Management Coding Services Optimized Powerful technology combined with expert knowledge and resources Improve clinical productivity, reduce costs and increase Medicare compliance with Premier Returns certified coding services. Billing Services Coding Services OASIS Review Home Health and Hospice Coding Managed By Certified Experts Simione Healthcare Consultants and HEALTHCAREfirst have come together to create Premier Returns, a complete Revenue Cycle Management solution unlike any other in the home health and hospice industry. Backed by more than 60 years of collective industry experience, Premier Returns combines powerful technology and superior outsourced services with expert consultation and advice. Now more than ever, home health and hospice organizations must submit accurate claims with proper diagnosis codes in order to be paid properly. Inaccurate claims can cost your business timely reimbursements and exhaust administrative time. Premier Returns outsourced coding services can improve coding accuracy, turnaround time and reimbursement at a competitive price. CODING MADE EASY The outsourced coding process is simple. We will log into your software system no need to fax or scan and upload hundreds of pages of clinical documents. Our certified coders will code the entire OASIS to ensure the 485 is correct. Each assessment will be completed by the end of the next business day. OUTSOURCED CODING n Increased accuracy n Faster turnaround time n Quicker reimbursement

6 B i l l i n g S e rv i c e s C o d i n g S e rv i c e s O A S I S R e v i e w Improve coding accuracy, turnaround time and reimbursement with Premier Returns certified coding services. PremierReturnsTTopBooth2014final.indd 1 Home Health & Hospice Coding Home Health Visit Cost Analysis Home Health Analysis Reports Premier Returns certified coding experts specialize in the home health and hospice industry. They are continuously trained on the latest regulations, including ICD-10. Our experts return coding events by the next business day, resulting in shorter reimbursement cycles and improved cash flow. Home Health, Inc. Home Health Visit Cost Analysis Average Direct Cost per Visit Average Supply Cost Skilled Nursing Physical Therapy Occupational Therapy Speech Therapy Coding Status Evaluation & Review Average Supply Cost per Visit Before we begin to manage your coding process, we will provide an initial check of your coding status to determine how your business is performing. Additionally, we will meet with you on a regular basis to discuss your current financial status and offer suggestions on how you can improve. Average Supply Cost per Unduplicated Patients Medical Social Service Home Health Aide Analytic Technology Copyright 2014 Simione Healthcare Consultants, LLC Provider # d Monthly Case Weight 1 of 18 Premier Returns provides comprehensive analytic technology that will allow you to see your business in a whole new light. This Web-based technology provides unmatched insight into your financial health including the identification of hidden trends in revenue performance, lost revenue opportunities, timeliness of claims, clean claim rate and much more. About Premier Returns Premier Returns is a joint Revenue Cycle Management Solution developed for home health and hospice organizations by Simione Healthcare Consultants and HEALTHCAREfirst. We saw a need in the marketplace for comprehensive revenue cycle management, as many agencies struggle with timeliness, cash flow issues, regulatory requirements, and lost income, among the growing priorities of running a home care or hospice organization. Together, we have all of the resources and expertise to solve these issues, relieving some of the pressure of revenue cycle management to help agencies concentrate on patient care sales@premier-returns.com

7 Revenue Cycle OASIS Quality Management Review Optimized Powerful technology combined with expert knowledge and revenue resourceswith Premier Returns Protect your OASIS review service. Billing Services Coding S e rvi c e s OA S I S Re vi e wour certified experts perform quality reviews of your charts and advise you on how you can improve. OASIS Quality Review Conducted By Certified Experts erreturnsttopbooth2014final.indd 1 6/13/2014 9:32:34 AM Simione Healthcare Consultants and HEALTHCAREfirst have joined together to create Premier Returns, a complete Revenue Cycle Management solution for the home health and hospice industry unlike any other. Backed by more than 60 years of collective industry experience, Premier Returns unites powerful technology and superior outsourced services with expert consultation and advice. When OASIS assessments are not completed properly, this can lead to reduced reimbursement, risk of audit, or even claim denial. Premier Returns OASIS review service ensures the accuracy of each episode so you are properly paid for the services you provide, while reducing the red flags that may warrant an audit. FAST TURNAROUND Our certified OASIS review experts will review documentation and care plans thoroughly for consistency and make recommendations based on the clinical documentation. Review will be completed by the end of the next business day. OASIS REVIEW n Increased compliance n Reduced audit risk n Accurate reimbursement

8 PremierReturnsTTopBooth2014final.indd 1 Billing Services Coding Services OASIS Review Ensure the accuracy of each episode so you are properly paid for the services you provide. OASIS Review Premier Returns identifies potential inconsistencies in OASIS and offers solutions on rectifying problems. Our certified OASIS review experts are specialists in home health clinical documentation and are always up-to-date on the latest regulations and requirements. They review the full chart, including physician orders, care plans/visit frequencies and clinical assessments. OASIS Status Evaluation & Ongoing Review Before we begin the OASIS review process, we will provide an initial check of your OASIS assessment status to determine how your business is performing. Additionally, we will meet with you on a regular basis to discuss your current financial status and offer suggestions on how you can improve. Average Payment Per Episode Analytic Technology Premier Returns provides comprehensive analytic technology that will allow you to see your business as you never have before. This Web-based technology allows you to follow your Medicare claims through the system, pinpointing where your cash flow is being held up and why, as well as identifying hidden trends in revenue performance, lost revenue opportunities, timeliness of claims, clean claim rate and much more. About Premier Returns Premier Returns is a joint Revenue Cycle Management Solution developed for home health and hospice organizations by Simione Healthcare Consultants and HEALTHCAREfirst. We saw a need in the marketplace for comprehensive revenue cycle management, as many agencies struggle with timeliness, cash flow issues, regulatory requirements, and lost income, among the growing priorities of running a home care or hospice organization. Together we have all of the resources and expertise to solve these issues, relieving some of the pressure of revenue cycle management to help agencies concentrate on patient care sales@premier-returns.com