Improve Revenue Management Services
Hospitals, health systems, academic medical centers and their physician practices are under pressure to improve the quality of care while simultaneously facing declining reimbursement, increased risk and margin pressure. In many healthcare organizations, maximizing revenue efficiency and improving the areas of medical billing, coding and accounts receivable management are overriding to achieving the goals defined by healthcare reform.
Partner with a Revenue Expert So You Can Focus on Delivering Quality Care
Identifying incremental reimbursement opportunities can deliver an immediate return without a large amount of time or cost. This first step gets your revenue in good working order as you go down the path of value-based care. WRC helps hospitals improve profitability with revenue circuit management services allotted to help them maintain focus on patient care. As an extension of team, we have the resources and intensity of experience you need to help strengthen the financial health and profitability of whole organization.
If healthcare organization is struggling to maintain its revenue operations, WRC end-to-end revenue cycle management and medical billing services can provide as much or as little help as needed. Our domain expertise in both physician and hospital billing and claims management, combined with end-to-end revenue management services, can help organization reduce operating costs and accelerate cash flow.
Essential Revenue and Management Services
Increasingly, chief financial officers are partnering with experts to administer core revenue and accounts receivable management processes to become more efficient and refine financial performance. As health systems fighting to take on professional-fee revenue responsibilities for newly employed practices, we can provide support to help manage coding, billing and technology platforms for both hospital and physician revenue management.
- Medical Coding and Healthcare Regulatory Compliance: From full outsourcing to episodically project work, our coding services address all sides of coding by identifying missed revenue opportunities as potential compliance risks due to inaccurate coding. We can help team with clinical documentation improvement, audit management, and staff training and education. A healthcare compliance plan assessment, development and monitoring program can help organization mitigate risk and focus on compliance improvement.
- Application Management: Our team scrubs procedural and diagnosis codes against Correct Coding Initiative and payer-specific edits. We provide charge capture audits to confirm that charges and receipts are not missed by reconciling patient charges in the hospital, office, clinics, surgery suites and more. We also review charge data prior to billing to help capture all charges and payments.
- Billing and Payment Management: From insurance billing and patient statements, to payment posting and validation, WRC can assist manage the critical processes that directly affect one of most important KPIs: AR Days.
- Extensive Business Office Services: Our team of experts can augment staff with both insurance and patient accounts receivable follow-up services. For insurance accounts receivable follow-up, we can contact payers to determine claim status and root causes of delinquent claims, and then provide the information needed to resubmit claims or initiate appeals. Our patient balance follow-up for self-pay payment collection is handled efficiently and respectfully. We use a predictive to place follow-up calls to patients to request payments and can help establish customized payment plans according to policies and procedures.
- Collections Management: Hospital can decrease bad debt and increase revenue by giving us the hard collect claims. Depending on needs, we focus on outstanding claims, including out-of-pocket amounts and across payer types, by age and by balance.
- Managed Care Services: Our contract experts can review third-party payer contracts, analyze future contracts and help prepare for payer contract negotiations. We can track managed care contractual agreements including renewal dates and contract terms to help maximize the profitability of current contracts.
Management Services that Address Cultivation Healthcare Trends
Necessity partnering with an expert for AR management services that have become increasingly important given these growing trends in healthcare: increasing complexity of payer contracts, mergers and acquisitions that affect system platform strategy, and the rise in self-pay accounts due to high deductible health plans.
- Medical Denials Management Underpayment Recovery: From full outsourcing of your denials resolution procedures to performing focused audits, our denials management team can offer much help as need to maintain control of financial performance.
- AR Conversion: We work through present accounts receivable balances while staff focuses on the new implementation and training. Our comprehensive support will help recover balances both prior to and after system conversion, capturing revenue that is commonly lost during times of significant change.
- Self-Pay Collections: We’ve established the right superposition of processes, technology and patient advocacy to help optimize collections and shorten collection cycles on patient balances. Acting as your extended business office, we help you reduce self-pay receivables, increase cash flow, reduce bad debt and optimize financial performance.
- Revenue Cycle Management Services: Healthcare revenue leaders are increasingly considering outsourcing hospital and physician revenue cycle management operations in light of growing pressures to preserve financial performance, keep up with ongoing regulatory changes, reduce revenue cycle costs associated with getting paid and shift their focus to improving the delivery of care. The WRC can provide health with integrated services and experience in managing income cycles in the form of a strategy that helps health systems improve income cycle management processes, become more effective and positively affect the financial health of the organization.
Revenue Insight and Analytics
Extension of business office staff, we help you accelerate cash collections through our best practice processes, automated tools and insight into revenue cycle.
- Monthly Reporting: We provide you with detailed monthly reporting of net revenue calculations and cash flow projections based on payer mix and monthly trending.
- Demand Analytics: WRC solution gives you on-demand access to organization’s detailed medical billing and accounts receivable data, providing powerful insights into revenue cycle with high-level dashboards, standard report templates, email report delivery and navigation.
- Account View: Improve collaboration between staff and ours to resolve account issues. Revenue and clinical teams can view patient account records to research patient inquiries and view billed claim history, facilitate requests for additional information, collaborate on recovering denials, and track and post time of service patient and other transactions entered by practice staff.