FAQ in Healthcare Administration & Solutions

Why Us?

With the industry moving to complex, value-based payment models, you need a partner to help navigate to the next level. Let us show you how to manage from Patient-to-Payment, taking a holistic view of the entire revenue cycle to create an integrated, high-performing ecosystem. Our in-depth healthcare industry expertise enables us to provide end-to-end solutions to successfully resolve our clients’ billing challenges, while embracing their overall business operations. Revenue Health delivers a world-class infrastructure of highly skilled professionals, robust processes, and next generation workflow solutions. This makes us an ideal partner for our clients. When you need a revenue cycle management company, we are the best choice.

With this said, our strengths are:

  • Technology & Data Driven – With Business Intelligence, Performance Metrics & Benchmarks
  • Process Oriented – With Transparency of Operations & Best Practices Approach
  • Accountability Culture - With Highly Skilled & Trained Members taking Strong Ownership
  • 24/7 Operations – With Continued Improvement Focus & Customizable Solutions
  • Compliance Oriented – With HIPAA, Coding & Billing Regulations

How do you assure quality?

We believe in giving you only the best & we believe in continued improvisation. Because we believe that, the only constant is distance. Some measure it. We bridge it. Revenue Health derives its strong maturity in execution through its focus on maintaining the highest quality standards across the organization. We achieve it through an adoption of best practices, established models and methodologies and an uncompromising approach to ensuring excellence in delivery. We have developed an excellent Quality framework. We practice the principles of each of these models to ensure processes are delivered according to the Service Level Agreement (SLA).

Each of these standards have been designed not only to eliminate defects but also the root causes of defects in business processes in order to work towards greater efficiency, productivity and accuracy

We also have well established processes in place to regularly obtain feedback from our clients and their end customers. This is another critical element, which helps us measure and continuously improve our stated quality standards.

What are your capabilities and what services do you offer?

  • Credentialing: Dedicated experts for credentialing verification to enhance efficiency
  • Eligibility Verification: Insurance verification and patient eligibility details
  • Charge Capture and Billing: Timely charge entry and submittal of error-free claims and cash posting
  • Coding: Accurate coding to maximize revenue and decrease compliance-related risks
  • Complex Claims: Manage the paper work and follow-up associated with your workers’ compensation, no-fault, and MVA claims.
  • Denial Prevention: Validation of superbills and/or electronic claim scrubbing to prevent clearing house/payor denials/rejections
  • A/R Follow-up: Constant communication with payers on accounts receivable using phone, email and web
  • Denial Management: Identifies unpaid claims or underpayments by payers at the individual claim level
  • Coding Audits: Recommendations for overlooked billing opportunities
  • Patient Collections: Answers inbound patient calls related to self-payment responsibilities
  • Platform Agnostic: Ability to work with multiple platforms

How do you work with EHRs and EMRs?

We understand the importance of provider training and adoption during new EHR implementation or conversion. Our One-On-One Provider EMR training is focused specifically on provider clinical workflows and typically takes about half the time of our Instructor-Led End-User Training.

Our EMR Training curriculum is customized to each client, with individual workflows defining a personalized approach. We have a unique approach, catering to individual user groups, ensuring a better learning experience. Our training experts can staff or supplement all of your training needs.

How do you keep us compliant?

The healthcare landscape is constantly evolving with new rules and regulations that are fundamentally changing the way physicians work and practice. The world of coding is just one of these frequent changes that occur on a regular basis. From ICD-9 to ICD-10 to RAC Audits to new modifiers, it is a challenge to keep pace with the new rules and coding practices.

Revenue Health has a team of certified coders that help physicians in 50+ specialties to not only code correctly but also look for opportunities where physicians may be under-coding. We can provide both proactive and retroactive coding audits to ensure that practices remain compliant with coding guidelines. In the daily life of a practice, it’s easy to repeat broken processes or mistype information due to the fast-pace environment.

CMS recommends that providers seek external reviews to help ensure that practices remain compliant in order to avoid potential fines and hours of time with paperwork. Revenue Health’s team has kept many practices compliant, saving them hundreds of thousands of dollars in fines. In addition, we’ve helped prepare organizations with proper self-reporting when experiencing an OIG audit.

What Revenue Health Delivers:

  • Proactive claim and document reviews identify coding and modifier errors
  • Expert coders help you avoid legal and financial exposure
  • Unbiased reviews prepare you for OIG and RAC audits
  • Comprehensive analysis of your contracts, claims, and payments to find potential underpayments
  • Allows your staff to focus on patients while receiving additional training and education from our experts

Can you help us with PQRS and Meaningful Use?

Physician Quality Reporting System (PQRS) is a healthcare quality improvement incentive program initiated by CMS. At Revenue Health, we aggregate, analyze, and electronically submit qualifying data to CMS thus avoiding penalties and gaining incentives on the physician practices.

Revenue Health’s Meaningful Use reporting provides the necessary data points and knowledge needed to assist our clients to intelligently manage their day-to-day operations, efficiently manage their communication protocols and more importantly to achieve consistent / predictable collection numbers. Our solutions ensure a comprehensive and relevant summary of key metrics designed to improve administrative, operational and financial performance. Its capabilities enhance the insight across the organization – from insurance calling agents to the executives – to more effectively manage their collection trends, determine actionable insights and analyze data in a more meaningful way. We believe our dashboards will assist the end users to manage their respective functional areas of the business more effectively.

In case you haven’t found the answer for your question please feel free to contact us, our customer support will be happy to help you.