PARA - Three Steps to Success

STEP 1 - I'd like to better manage:

Reducing Self Pay Bad Debts
Unnecessary, Underutilized, Multi-Platform, Costly Revenue Cycle Software
Pricing Transparency
Cost Mark-Up Compliance for Drugs and Supplies
Revenue Cycle Staff Shortages
Coding, Billing Reimbursement Resources
Daily Charge Master Maintenance Process Flow
Market Based Pricing
Eligibility Process Issues
Physician Practice Pricing
Optimizing Managed Care Payer Contracts
Point of Care Collections
Compliance of Evaluation and Management Levels

STEP 2 - Identify My Process Improvement Goals:

Reducing Self Pay Bad Debts
Provide Out-of-Pocket Responsibility to Patients
Develop Internal Charge Quotation Process
Add Transparency Module to Hospital Website

Unnecessary, Underutilized, Multi-Platform, Costly Revenue Cycle Software
Single Source Software Solution
Minimize Time Spent Communicating with Vendors
Cost Savings with Bundled Services
No Software to Install

Pricing Transparency
Ensure Competitiveness in the Market
Add Transparency Module to Hospital Website
Integrate Insurance Settlement into Patient Quote Process
Develop Internal Charge Quotation Process

Cost Mark-Up Compliance for Drugs and Supplies
Reduce Self-Administered Drugs
Move from using AWP to Another Cost Method (WAC, SWP, Acquisition Cost)
Improve Net Revenue
Update Charge Categories to Industry Standard (Oral, Injection, Intravenous)
Move Supply Prices Back to a Cost-Based Mark-Up
Identify Nonbillable Items from Charge Master
Identify Billable Items not Currently Charged
Developed/Improve Supply/Pharmacy Charging Policies

Revenue Cycle Staff Shortages
Monthly Revenue Integrity Meetings with Industry Experts
Ongoing Support for Billing, Coding, and Compliance Issues
Review Claims and Identify Possible Compliance Issues
Support Updating Charge Master System and Pricing Using Remote Access
Assistance for Accounts Receivable Follow Up
Create/Improve Process Flow for Add/Changes/Deletions to Charge Master
Support IT transitions for Compliance, Medical Billing, and A/R Clean Up

Coding, Billing Reimbursement Resources
Access to Most Up-to-Date Resources
Monthly Revenue Integrity Meetings with Industry Experts
Ongoing Support for Billing, Coding, and Compliance Issues
Provide ICD- 10 CM, PCS Training by a Certified Trainer
Assess Coders Skillsets
Reduce Coding Backlog

Daily Charge Master Maintenance Process Flow
Monthly Revenue Integrity Meetings with Industry Experts
Ongoing Support for Billing, Coding, and Compliance Issues
Create/Improve Process Flow for Add/Changes/Deletions to Charge Master
Support Updating Charge Master System and Pricing Using Remote Access

Market Based Pricing
Pricing Transparency
Increased Net Revenue
Ensure Competitiveness in the Market
Confirm Prices over DME, ASC, Physician, and Clinical Lab Fee Schedules
Develop Internal Charge Quotations Process
Add Module to Hospital Web Site
Integrate Insurance Settlement into Patient Quote Process

Eligibility Process Issues
Real-Time Availability of Copay/Deductable Information
Insurance Coverage Validation

Physician Practice Pricing
Understand Reimbursement Methodoligies for Various Payers
Maximize Reimbursement Opportunity
Develop, Rational, Well-Defined, Competitive Pricing Strategy

Optimizing Managed Care Payer Contracts
Assistance in Modeling Contract Proformas
Capture Earned Reimbursement
Optimize Managed Care Contracts

Point of Care Collections
Reduce Bad Debt
Increase Cash Flow
Attract Good Payer Mix
Develop Internal Charge Quotation Process
Add Module to Hospital Web Site
Ensure Competitiveness in the Market

Compliance of Evaluation and Management Levels
Prepare for Hospital ED and/or Professional Audit
Improve Compliance
Avoid Inadvertent Over-Coding
Avoid Under-Coding
Reduce Claim Denials
Provide Education & Training
Improve Revenue

STEP 3 - Let's Talk!

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Morning Afternoon

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