Rycan Revenue Cycle Management Solutions Overview. Target Audience: Evident and Healthland May 18, 2016

Transcription

1 Rycan Revenue Cycle Management Solutions Overview Target Audience: Evident and Healthland May 18, 2016

2 Rycan Revenue Cycle Management Solutions (RCM) Overview Session Presenters: Jody Heard Industry Marketing Director Business and IT Solutions Jamie Hodge Solution Consultant Rycan, Healthland, AHT Target audience: Evident and Healthland Recommended for: Executive Financial / Accounting Business Office HIM Information Systems Registration

3 Learning Objectives Gain an Introduction to Rycan and Rycan s Solutions Acquire Insight into the Advanced Revenue Cycle Solutions Available to Your Organization

4 Rycan Overview

5 Rycan Overview A leader in healthcare Revenue Cycle Solutions for over 30 years. Built our reputation by providing best-of-breed software encompassed by a level of customer support that is unparalleled in the healthcare industry. Rycan s Solutions enable healthcare providers of all sizes to increase revenue, accelerate reimbursement and improve efficiency through optimization of your Revenue Cycle process.

6 What Differentiates Rycan The most important distinction between Rycan and other revenue cycle software vendors, is our approach to our solutions. Rycan builds best-of-breed software solutions. Rycan determined early on that it would not try to compete with the hundreds of vendors who build or rebrand anemic products that were designed to offer just enough functionality, to be sold as a program. Rycan offers software solutions that were designed, built and tested to be leaders in their respective categories.

7 Rycan Overview Market Trends This devotion to providing cutting edge technology is especially important in today s difficult financial times where Revenue Cycle prowess is no longer a luxury, it is a requirement. Providers today face an increasing array of challenges including: Decreasing margins; Increasing denials and Bad Debt; Growing cash flow shortages; Mounting reimbursement complexity; and Heightened regulatory scrutiny.

8 Rycan Overview Market Trends Reimbursement methods and models are changing at a faster pace than ever before. Quality of Care Accountable Care Organizations (ACOs) Value-based Reimbursement Added to that is the fact that most providers have seen their patients become their largest payer as a result of High-Deductible Health Plans.

9 Rycan Overview Through our hands-on approach and direct partnership with our clients, Rycan s suite of Revenue Cycle Solutions has been designed from the ground up to resolve these real-world, Revenue Cycle issues with cutting edge software solutions.

10 Our Solutions include: Rycan Overview Patient Liability Estimates Eligibility Verification Claim Scrubbing and Submission Medicare Direct Medicare Navigator Claim Status ERA Retrieval Remittance Management Deposit Reconcile Denial and Audit Management ESMD Contract Management

11 Patient Liability Estimates High Deductible Health Plans have been the single greatest contributor to many healthcare organization s rise in Bad Debt. They have also been one of the largest drivers behind sweeping process changes in most organizations registration departments. Front-end collections have become standard for most healthcare providers. Shopping around and price comparisons are becoming the norm for most patients.

12 Patient Liability Estimates Rycan s Patient Liability Estimates Module resolves both of these issues by calculating a statistical average of your organization s historical claim and remittance data, factoring the patient s insurance information and applying any applicable discounts to provide accurate, up to date, estimates of the patient s out-of-pocket expenses before the time of service. This information can be utilized to reduce your Bad Debt by implementing a front-end collections process as well as improve patient satisfaction by enabling factual financial conversations to occur before the time of service.

13 Eligibility Verification Healthcare providers face an array of denied claims everyday in their business offices. A significant portion of these can be traced back to the registration process and inaccurate insurance information. Having incorrect insurance information on a claim dramatically affects an organizations billing process increasing their overall AR Days.

14 Eligibility Verification Rycan s Eligibility Verification Solution enables your staff to validate a patient s insurance eligibility in realtime during the registration process ensuring accurate billing and timely reimbursement.

15 Claim Scrubbing and Submission Growing cash flow shortages are driving many providers to scrutinize delays to their billing process. The sooner that a claim is submitted to the payer and the more accurate the information on that claim, the sooner payment is received. Organizations are becoming keenly aware of the immense cost of labor and resources involved in resolving front-end claim rejections, back-end denials, and defending audits.

16 Claim Scrubbing and Submission These factors are driving many organizations away from the simple pass-through clearinghouses of the past and towards full-featured claim scrubbers with deep content validation. Automatically identifying and correcting claim billing issues before submission to your payers dramatically reduces your overall cost as well as the time it takes to get reimbursed.

17 Claim Scrubbing and Submission Rycan s Claim Scrubbing and Submission Solution is superior to that of the other clearinghouses that you will see in this industry because it is truly a fullfeatured software solution designed to ensure your claims are billed quickly and accurately. One of Rycan s largest differentiators, is the degree to which we scrub and validate claim information. Rycan s claim validation process includes over six million rules and edits ensuring that your submitted claims are truly healthy and compliant.

18 Claim Scrubbing and Submission Further enhancing Rycan s built-in edits, your staff have the ability to create their own, customized edits real-time within the system enabling you to custom tailor your claim submission process and instantly adapt to payer and billing changes. In addition to this deep content validation, Rycan s workflow tools automate and simplify your staff s dayto-day activities including: Secondary Billing / COB Enrichment Claim Attachments (electronic and paper) Medicare Shadow Claims Printed Paper Claims

19 ERA Retrieval and Remittance Management The requirement to streamline and accelerate the posting process has driven most facilities to embrace electronic posting of remittance data. However, obscurities in the file specifications and minimal enforcement of payer compliance has caused many organizations to struggle with electronically posting their remittance information.

20 ERA Retrieval and Remittance Management Rycan s remittance solutions not only automate the process of retrieving electronic remittance files from the hundreds of payers that you do business with, but also scrub and normalize that data ensuring that your organization will be able to post that information to your host system. As with Claim Scrubbing and Submission, these edits can be custom tailored around your organization s unique posting needs.

21 Denial and Audit Management Ever increasingly complex reimbursement models are causing an increase in denials across the industry. Organizations are quickly realizing that the sheer volume of denials today is unmanageable with their current staffing levels through a manual process and the financial impact of not resolving these denials is detrimental to their financial health.

22 Denial and Audit Management Added to this is the fact that governmental and payer audits have gone viral. RACs are Back Medicare Advantage, Medicaid, and Commercial payer audits are on the rise Across the nation, healthcare audit teams are seeing a significant increase in risk adjustment audits and their associated medical record requests.

23 Denial and Audit Management Rycan s Denial and Audit Management Solution ensures that every denied claim is identified and assigned to the appropriate staff member, providing them the tools necessary to appeal and resolve the problem claim. Root cause analysis, denied claim follow-up and claim resolution are simplified with Rycan s automated workflow tools. Audited claims are easily tracked, appealed, and resolved through this same comprehensive solution.

24 Contract Management Reimbursement complexity is growing by the day. This complexity and the sheer volume of transactions your organization processes makes it impossible to manually verify payer contract compliance for every claim. The introduction of new payment methodologies like APR-DRGs and EAPGs opens the door even wider for payment variances and payer mistakes. Electronic Contract Management systems have become a necessity for an organization s day-to-day operations.

25 Contract Management Rycan s Contract Management Solution empowers you to take control of your contracts. Predict Payments on claims before they are paid Prospective pricing functionality provides accurate, instantaneous analysis of your cash flow, detailing expected payments as well as anticipated write-offs Verify every claim was paid correctly Retrospective pricing validates that you received proper reimbursement on every claim.

26 Contract Management Model payer contracts during negotiations Modeling your contracts within Rycan enables you to level the playing field during negotiations. Entering the proposed contract terms into the system and comparing that contract side-by-side against your current contract quickly identifies the underlying financial impact your facility will face.

27 TruBridge and Rycan Integration is already underway between Rycan s Revenue Cycle Software Solutions and the advanced knowledge, expertise, and processes of TruBridge s Services and Staff. The integration of these two industry leading organizations enables the creation of a single, seamless solution which spans the entire spectrum from a fully outsourced business office to an empowered in-house revenue cycle department with access to the expertise of some of this nation s leading consultants.

28 Live Software

29 Additional Rycan Education Claim Scrubbing and Submission Thursday, May 19 at 10:30 a.m. Patient Liability Estimates and Contract Management Thursday, May 19 at 2 p.m. Request a demonstration of Rycan s Solutions at the Expert Area. Contact your sales representative to schedule a full demonstration of Rycan s solutions.

30 Thank you!