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REVENUE CYCLE MANAGEMENT SERVICES

 

Growing service demands, thin operating margins, changing regulatory landscape and intense competition continue to challenge Hospitals, Providers and Health Systems. Ineffective revenue cycle management can cost a hospital up to three percent of annual net revenues. With the current trend of high deductible health plans, the ability for the healthcare provider to accurately estimate the patient portion of billable charges has an impact on receivables. Compliance & Internal controls play a vital part in reducing the risk associated with heightened scrutiny from governmental bodies challenging the Medicare and Medicaid coding and billing practices of health care providers.

Rising healthcare costs coupled with the possibility of 10.6% cut in claims payouts by CMS post 2009 pose challenges to the Healthcare industry to cut cost, increase revenue and stay profitable. Rising healthcare cost have resulted in focus on preventive care and disease management. Providers are now facing new challenges of manpower management, shortage of skilled resources, reporting and implementing management programs.

In this high-pressure environment, managing your bottom line has never been more critical. iSpace's revenue cycle management solution help provider organizations achieve their goals of higher-performance in revenue management while bringing in best practices that impact control and compliance.

iSpace’s comprehensive suite of revenue cycle management services are customized to meet our clients' requirements and deliver immediate bottom line benefits by streamlining the entire revenue flow to optimize profitability.

iSpace brings best practices to all patient interactions from pre-registration data collection, eligibility, coding and billing to payments and reimbursements.

iSpace’s Revenue Cycle Management Services include:

Consulting & Business Process Analysis: Our revenue cycle consulting service helps analyze your current revenue cycle operations and focuses on ways to improve workflow and recover lost revenue. Poor revenue collections stem from multiple root causes including deficiencies in education, training, staffing levels, process workflow, and poorly implemented IT applications. Each deficiency must be addressed as part of a coordinated solution to obtain real improvement.

As part of the consulting process, our six sigma consultants establish baseline measurements of a provider's financial and revenue cycle performance and create applicable benchmarks. As part of the Analysis a detailed operational assessment of the current revenue cycle process is created with opportunities identified for improvement. A detailed desired state process is created with recommendations for the creation, and implementation of workable solutions for revenue improvement.

CBO Outsourcing:Our revenue cycle solution integrates the right combination of people, processes, and technology to help our clients optimize revenue, improve cash flow and enhance productivity. Our professionals can help with:

  • Business office and patient access management.
  • Patient scheduling.
  • Insurance & Eligibility verification.
  • Patient registration.
  • Third-party billing and follow-up.
  • First-party reimbursements, B2B collections.
  • Cash posting, GL entries and adjustment processing.
  • Denial Management.
  • Customer service & reporting.

A/R Management:As a non-core business function within most Provider CBO's, the AR process is neglected leading to ineffective cash flow. iSpace has a proven track record of improving cash flows with both upstream and downstream feedbacks to improve billing and cash posting efficiently, leading not only to better collections but also complementing relationship management with all vendors and customers.

Coding:Our certified coders understand that coding is the cornerstone for reimbursements, compliance and outcome analysis. Our coders are well trained to evaluate and interpret health records, supporting documentation and reports to accurately code diagnoses and procedures according to recognized standards. Our coders are proficient with CPT, ICD-9, and HCPCS coding across various specialties, insurance and governmental regulatory requirements and payer-specific coding requirements. Our coders currently code for individual physicians, physician groups, free standing diagnostic facilities, long term care facilities and hospitals.

Following are some of the specialties we have expertise in:

  • Anesthesiology
  • Cardiovascular Surgery
  • Cardiology
  • Chiropractic
  • Dermatology
  • Emergency Medicine
  • Endocrinology
  • Family Practice
  • General Surgery
  • Gastroenterology
  • Geriatrics
  • Hematology / Oncology
  • Internal Medicine
  • Neurology
  • Neurosurgery
  • Nuclear Medicine
  • Obstetrics
  • Gynecology
  • Orthopedics
  • Pediatrics
  • Plastic Surgery
  • Pain Management
  • Pathology
  • Psychiatry
  • Podiatry
  • Pulmonary
  • Radiology
  • Urology
  •  

    Benefits from RCMS:

    By outsourcing the CBO to iSpace, clients can realize measurable and sustainable results and improvements to the bottom line such as:

    • Increased net cash
    • Bad debt reduction
    • Controlled DRO and DSO
    • Improved relationships with both physicians and patients

    As the bottom line improves, our revenue cycle solutions indirectly help drive improvements to the quality of the services you provide.

    Technology:

    As part of our service delivery, iSpace can bring the following technology & services to improve the RCMS process:

    • Document Management System.
    • Mail room services.
    • E-Billing engine and service.
    • E-Eligibility verification engine.
    • Workflow automation system.
    • Remote coding systems.
    • Denial Management system.
    • Debt collection software.
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