Category: For Hospitals & Physician Groups

Apply revenue assurance control to know what you are owed, collect what you are due, and negotiate what you are worth.

Is your road to claims processing filled with roadblocks and other delays? Download our infographic and learn how to steer around cash flow obstructions.

With manual transactions costing on average $4 more than electronic, isn’t it time you ask yourself, “How can I tame the Paper Storm?”

In the Healthcare industry, mergers and acquisitions (M&A) are everywhere. Even among the revenue cycle vendors who serve the industry, consolidation is the new constant. But what does this mean for you and your healthcare organization?

When a merger occurs, the newly formed vendor conglomerate may choose to convert acquired clients to a single system rather than carry the cost of supporting multiple product platforms. Through no choice of your own, your organization may be faced with the cost of an unplanned RCM system conversion.

During M&A integration, customers from both companies will face changes. How these changes impact customer choices can immediately impact customer experience. When you chose your RCM vendor, you sought the software, service, and support that best met your healthcare organization’s needs. How will the changes you are being forced to make impact your revenue cycle and reimbursement needs?

If you are being forced to make a system change, do not feel trapped by your current RCM vendor. Take back control—consider all your options. Revisit your decision model. To get started, review the 8-Item Checklist for Picking the Right RCM Partner and the Top 5 Ways to Optimize RCM Management. Focus on those capabilities you need to successfully drive your organization’s mission: data analytics, operating efficiency, and technology integration.

Data Analytics – Put Your Data to Work

Look for an RCM solution that provides visibility into your revenue cycle so you can gain insight, take action, and deliver results. Select a solution where you can monitor KPIs and benchmarks to uncover actionable patterns in your billing and reimbursement data. Make sure it has an analytics front-end that presents easily-consumable dashboards and reports—visual charts and graphs—so you can quickly identify trends and quantify impact to make data-driven decisions.

Operating Efficiency – Take Control of Your Cash Flow

You need your revenue cycle to be a highly-functioning, results-oriented operation. Find an RCM solution that will automate your claims, fast-track your receivables, and coordinate your denials and appeals management efforts. All with configurable workflows that you control and customize.

Technology Integration – Connect Everything

The right RCM partner will have technology that interfaces seamlessly with your EHR. To promote seamless integration, your RCM solution should be able to support APIs, web services, and both standard and non-standard interface types—making data connections secure, controlling access with minimum necessary use while not impeding productivity. Find a vendor who combines smart technology with superior service.

Mergers and acquisitions favor the joining partners. Customers and clients can be in for a rocky transition, especially if vendors have not fully vetted their M&A integration plan. If you are facing an unplanned RCM system conversion due to vendor consolidation, why not choose the vendor that fits you best? Make the choice that serves your RCM needs today and in the future. That may, or may not be, your newly formed vendor conglomerate.

Optimize Unplanned Transitions – Choose Agile Stability

While considering your RCM options, you may want to learn more about The Quadax Advantage.Demonstrating agile stability in the midst of healthcare’s ever-changing ecosystem, Quadax delivers innovative RCM software, service, and support. An enduring industry expert, with more than 40 years of healthcare experience, we provide clients a continuity of excellence. Creating connections, providing intelligence, and equipping providers, Quadax can help optimize your revenue cycle.

Thrills and chills may be fun at Halloween, but not when staff is trying to process claims. Things that go bump in the night can be causing payment delays! Exorcise the ghosts in your revenue cycle—review these ghost busting tips and get the most from your RCM claim processing and clearinghouse solution.

Feeling Vexed by Your Automation’s Limitation?

Intelligent automation throughout your claims process can help accelerate your revenue cycle. Are you experiencing ghastly gaps in your automation?  What can you do about it?

Frequent interruptions caused by your upload routines can make staff fear the start of a new day. If daily interfaces are failing, you may want to implement custom interface logic and monitoring tools. This can improve claim data integrity while safeguarding staff productivity.

When front-end payer rejections prevent your claims from reaching payer adjudication, it may be time to consider a new clearinghouse. If your claims first pass rate is less than 99.6%, then your RCM is being impeded by an under-performing editing engine. Your claims processing engine needs access to the must current industry rules for cleaner claims and faster reimbursement.

You cannot afford to still be processing paper when electronic options are available. If you are still sending hardcopy claims, engage your clearinghouse’s electronic payer connections to send more claims electronically. Electronic processing can expedite payment by cutting claim processing lead time by more than half.

Feeling Poorly About Productivity?

With the right RCM tools and resources, staff can enhance productivity and optimize claim processing. Are frightful system inefficiencies terrorizing your staff? Identify where and when and ways to solve them.

Repetitive manual processing delays all good men and women from achieving their best. Do not allow your staff to be held hostage by the RCM vendor who only allows for custom programming. Enable your staff with high-performance tools and resources. Your RCM solution should allow your staff access to self-help options for engaging your system’s automation. We recommend easy-to-use wizards where staff operators can create auto-correct rules and custom claim edits specific to your business needs.

Paper worklists limit management’s ability to optimize your billing operation and balance workloads. Make sure priority claims are worked first. Organize your labor force using configurable electronic worklists, integrated reports and dashboards, to prioritize work for maximum effectiveness.

Clumsy communications among claim processing teams can put your organization at risk for security issues and inappropriate disclosures. Stop staff from using emails and shared spreadsheets. Expect your software to provide for cross-functional, interdepartmental workflow and communication, especially when a claim requires special handling. It should also provide for automated comment records to keep staff and systems in-step and in-sync.

Feeling Devastated Over Missed Deadlines?

One of the most deadly claim processing errors is missing a payer filing date. Is your RCM system allowing you to miss filing deadlines?

Do not let your revenue be defeated by the walking dead; make sure your claims never miss a deadline. At-a-glance dashboards and warning flags can help you monitor age of claims and days in A/R so that filing dates are managed and met.

At Quadax, we aren’t afraid of ghosts!

If there is something strange in your RCM neighborhood, something’s weird and it doesn’t look good, who can you call? Quadax Xpeditor™ can free your RCM of haunted processing.

Make sure your claims reach payer adjudication. When selecting a clearinghouse, compare first pass rate—percentage of claims accepted for adjudication on initial submission. A difference of one percent can represent thousands of claims. Learn more about Quadax’s industry-leading 99.6% first pass rate.