Revenue Cycle Management

Transcription

1 Revenue Cycle Management Manage and Improve Your Results with Origin RCM Financial pressures are escalating for both healthcare providers and patients. In this challenging climate, a wellmanaged revenue cycle is essential to minimize administrative duties and to ensure maximum, timely payment. Origin RCM can help manage and improve your revenue cycle with a comprehensive portfolio of easy-to-use solutions and services. Origin RCM is a unique revenue cycle management platform that combines differentiated technology; a full service, end-to-end revenue cycle solution; exceptional client management; and a culture of operational excellence. Origin uses its own proprietary analytics platform, Origin Analytics, to progressively optimize the operation and value of our revenue cycle management platform, allowing us to maintain one of the lowest accounts receivable days outstanding in the healthcare industry. This analytics and reporting technology also enables healthcare organizations to identify and quickly resolve specific workflow issues. Our technology platform automates historically labor intensive functions into repeatable, scalable electronic functions by combining unparalleled management and workflow functionality. It also allows us to effectively serve multiple specialties across the entire physician market.

2 What is Revenue Cycle Management? Revenue cycle management comprises all of the processes and efforts that you, as a healthcare provider, undertake to receive payment for services. The escalating pressure on providers, coupled with declining reimbursement rates, elevates the importance of revenue cycle management services within the healthcare landscape. Revenue cycle management activities begin at the first point of contact with the patient and continue throughout the patient lifecycle. Origin has the infrastructure and administrative expertise to effectively manage and optimize your entire revenue cycle. Origin s rigorous processes have resulted in an industry-leading 99% first pass claim rate. Origin RCM encompasses every area along the revenue cycle continuum: before, during and after a patient encounter.

3 Revenue Cycle Management Continuum Pre Visit Includes all processes that take place prior to the patient encounter. Data accuracy in this phase of the revenue cycle is critical to creating clean claims and maximizing revenue through back-end collections. Industry studies indicate that 90% of denied claims are caused by inaccurate collection of patient information on the front end. The source of payment and patient demographic information are critical data points that significantly impact payment results. Patient Encounter Includes physician/patient encounter related documentation such as transcription and coding. Proper documentation is critical to ensure proper billing and clean claims. Back End Includes all billing, follow-up and cash collection processes. The success of this phase is highly dependent on the pre-visit and patient encounter phases. 15% of each dollar spent on healthcare is used on the payment process. Source: MGMA Patient registration Scheduling Insurance eligibility Benefit authorization Medical necessity PRE-VISIT Payment posting Claims adjustment/ follow-up BACK END Revenue Cycle Management Continuum Electronic adjudication Denial management Accounts receivable management Analytics PATIENT ENCOUNTER Coding Diagnosis classification Case management Transcription Checks and balances for clean claims submission Regulatory compliance Financial counseling

4 Managing a physician practice or other healthcare organization is growing more complex every day. Reimbursement rates are declining and operating costs are rising. Complicated payment systems, billing processes and compliance requirements can lead to decreased profit margins and slow collections. Leading healthcare organizations are mitigating these challenges by adopting outsourced revenue cycle management solutions. MGMA estimates that 25% of potential revenue goes uncollected in many medical practices. Our solutions are designed to help clients capture this lost revenue. When you consider implementing a revenue cycle management solution, consider the following questions: How can I increase my revenue and cash flow? Our analytics solution, Origin Analytics, is employed by numerous healthcare and technology leaders because of its ease of use and superior analytic and reporting capabilities. Healthcare organizations can identify procedures that generate the most revenue, gain a better understanding of the business by examining where money is being spent, outliers, collection rate by payor, days in accounts receivable or average reimbursement. Examining these areas provides a holistic view of your organization and will improve financial performance and efficiency. Am I getting paid 100% from payors? How can I collect money that is owed from patients? Origin helps to facilitate timely collections of patient payments through a variety of collection strategies such as: Flexible payment plans Statement generation Credit card information retention for future expenses Our technology solutions ensure you are able to collect money owed and outstanding balances from patients. We also perform follow up calls to patients to obtain overdue balances in the least intrusive manner possible, respectfully maintaining the patient/provider relationships your practice has built. 40% of claims that are denied on the first submission are never resubmitted. Source: CMS; cms.hss.gov Nearly half of all claims are not paid correctly. This is generally due to an incorrect contracted rate being applied to the claim or the claim not being reviewed by in-house staff. We utilize technology solutions that electronically review payor contracted rates and flag underpayments, ensuring maximum timely reimbursement. How can I start improving the financial health of my practice? We offer a free benchmark analysis to compare your practice performance to others in your specialty. We will identify areas for improvement and determine methods to increase your cash flow. Our report outlines a projection of how much more you will collect using Origin RCM. With Origin as your revenue cycle management partner, you will see significant increases in collections. We will perform a comprehensive review of fee schedules, analyze the competitiveness of payor contracts and make recommendations for improvement, and help fix broken processes, resulting in increased efficiency.

5 Origin uses its own proprietary analytics platform, Origin Analytics, to progressively optimize the operation and value of our revenue cycle management platform, allowing us to maintain one of the lowest accounts receivable days outstanding in the healthcare industry. The benefits of using our tailored, integrated solutions are significant: increase revenue generation faster claims processing, prompt denial management and an industry leading first pass claims resolution rate of 99% allow our clients to experience increased cash flow and decreased claims in accounts receivable. increase practice efficiency we handle billing related phone calls and paperwork so you can spend more time with patients. Your administrative costs and bad debt associated with the complex billing and reimbursement landscape will decrease. Inform business decisions we provide technology solutions that enable you to monitor key business and clinical metrics, identify areas for improvement and increase revenue generation. Comply with laws and regulations we closely follow and abide by all rules, regulations and requirements and notify you of any important changes that may impact your business, mitigating your liability exposure. Our service includes transitioning to ICD-10. The Origin RCM platform was able to flag over $2 million in underpaid claims which we were able to verify and recover from just one payor. David Kanzler, CEO, Hinsdale Orthopaedics

6 Let Our Experience Work for You. Origin is a premier provider of revenue cycle management and analytics solutions. Origin solutions seamlessly integrate into any environment with a data-driven approach that is backed by world-class service and 20+ years of specialty-specific experience. Tens of thousands of providers have partnered with Origin to optimize their business results. Revenue Cycle Management Healthcare Analytics Transcription Services Contact us to learn more [email protected] originhs.com Offices Connecticut, Florida, New Jersey, Pennsylvania