There are multitudes of moving parts in all phases of the billing and collection life cycle from front end data collection to successful claim submission to completed back office activities, all designed around the goal of receiving payment for the work you perform.
And while it can appear to be a tangled web of never ending tasks, Emprove Practice Solutions has the experience and expertise to take the complexity out of your billing and collections. Our performance model reviews each part of your billing and collections life cycle to ensure each stage is programmed to work smoothly and make adjustments where it is not.
A vital part of billing and collection performance is the ability to compare your current metric performance to best in class industry standards, specifically around a small number of key performance indicators. We develop metric reporting within your practice management system, compare actual to best in class performance, and then create actionable plans designed to move you from average to outstanding.
Billing and Collection Life Cycle
Front End Revenue Cycle
- Support Front End Operations for efficient and accurate
– Patient Registration
– Insurance Eligibility
– Time of Service Collections - Coding support for providers and staff for CPT and ICD10
- Maintenance of Fee Schedules
- Provider Credentialing and Enrollment
Middle Office Revenue Cycle
- Claims scrubbing for coding and registration
- Claims submission
- Resolution of claim rejections – identification of root cause
- Denial avoidance
Back Office Revenue Cycle
- Payment Posting
- Payment Reconciliation to Bank Deposits and Posting
- Denial root cause and resolution
- AR Follow Up and Appeals
- Patient Statements
- Bad Debt management and minimization
- Patient AR Follow Up and Collections
- RCM Metric reporting and analysis
- Reimbursement analysis and contract reporting
- Key Performance Indicators for resource monitoring
Philosophy : Root Cause + Resolution = Results
