Consulting and Implementation Services
Healthcare Revenue Strategies (HRS) provides assessments, consulting, implementation services and tools to aid healthcare organizations in the effective management of revenues, claim generation and remittance analysis. Failure to resolve ongoing issues with insurers, no matter how volatile the climate on the health insurance front, leads to waste that could affect the performance of hospitals and other healthcare providers.
Our team of experienced Revenue Cycle Professionals has been providing expert application, project management, and is approaching two decades of consulting services to the healthcare sector. We bring our knowledge, expertise and professionalism to your organization.
Health care management consulting in the United States alone represents a $20 billion industry and growing, according to Hospitals & Health Networks (H&HN), healthcare providers must choose their consultants wisely. Our job is to assist our clients in dealing with the increasing complexities in claims which, unresolved, cripple their overall performance and increase costs to patients.
Denial management is a critical stage in the billing process that hospitals and other healthcare providers are often ill-equipped to handle efficiently on their own. The typical consumer is likely unaware of this specialty and the impact it may have on the revenues of medical providers. The bottom line is that resolving issues with insurers is ongoing and HRS professionals will be there to, among other things, make sure those claims are paid on behalf of patients.
At Healthcare Revenue Strategies we believe our expertise and experience are invaluable in the world of healthcare financial management. HIPAA (Health Insurance Portability and Accountability Act) regulations make it even more complicated and create more restrictions for healthcare organizations in resolving insurance claims.
Errors in processing medical claims alone cost the healthcare system in the United States billions of dollars every year. Failure to follow up properly on claims that are denied or put on hold is also a huge factor in claims being paid in full instead of getting lost in a stampede of claim denials. Revenue efficiency simply means that healthcare organizations get what is owed to them through the coverage of their patients.
Denial management is essentially about timely response. We partner with hospitals to identify the issues and take corrective action. That ticking clock is set in motion by insurers who give healthcare providers just so many days to respond before claims are denied, even if it is just a matter of clarification or a procedural flaw.
Some detective work is required, because it is critical to find out why claims are being denied and, based on that knowledge, making sure more claims are paid with the first submission. Expert analysis of electronic health records reveals that claim denials often show up as trends that can be identified and resolved, saving time and increasing revenues.
Managing and maximizing revenues for hospitals is more than denial management. We also bring in the right personnel, services and tools for the effective oversight of all revenues, overseeing those electronic health records, notably as a MEDITECH consultant, and ensuring that patient medical histories are accurate and compatible with records in the files of physicians who have treated these patients.
What do our consulting & implementation services include?
HRS will review the areas within your organization that have a direct effect on Revenue Efficiency. Full audits include interviews with key personnel, a complete review of claims, claim checks, proration rules, billing groups and other areas. HRS provides preliminary and final written assessments and detailed recommendations. HRS will supply the right mixture of project management, leadership, planning and hands-on implementation to meet your organization’s goals and expectations. Our team of experts has implemented dozens of remittances for numerous payers and organizations.
References are available upon request
For a small investment, the return was substantial. Since implementing HRS’ Process Improvement Program, my team has been able to sustain the program and continued cash collections are better than ever.Rebecca Hilbig