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Best Practices….

“Cost Saving Process Improvement for Healthcare

Revenue Cycle”

Presented by;

RevCure Consulting Inc.

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TABLE OF CONTENTSAbout RevCure Consulting Inc.Front End Best Practices OverviewCost Saving Solutions for Revenue Cycle

ImprovementFront End Solution(s)

- Solution Description- Screen shot workflow- Understanding the Value

Back End Solution(s)- Solution Description- Screen shot workflow- Understanding the Value

ConclusionHow to Get Started……..

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About Revcure Consulting Inc.RevCure Consulting Inc. (RCI) is dedicated to using its

experience and knowledge to assist providers with Revenue Cycle improvement by connecting a providers revenue cycle needs with the best fit solutions and ensuring a successful implementation.

RCI Experience:

Personally advised over 200 CFO’s on Revenue Cycle TechnologyImplemented Revenue Cycle technology at over 75 HospitalsGuest speaker for ‘Revenue Cycle Process Improvement’ at AAHAM, NAHAM and HFMA conferences hosted across the country

RCI Services:

Revenue Cycle Solution Services (matching client needs with best fit vendor solutions)Solution Implementation (managing the start to finish process of implementing new solutions)Contract Review and Negotiation for current and new vendor solutionsVendor/Solution replacement (finding vendor solutions that can replace current failed solutions/vendors)RFP/RFI management and grading process 4

Overview: Front End Demographic, Insurance and Financial Verification

Best Practice Process:

• Automated identity verification (name, address, SSN, DOB and Phone #) at patient registration

• Fraud Identification (Red Flag compliance)• Insurance Verification for Medicaid, Medicare

and Private Payers• Automated healthcare financial assessment based

on credit report data (includes charity decisioning and ability to pay)

• Automated real-time pop-up box on registrars screen with demographic, insurance and/or financial info for optimal processing time and registration accuracy

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Why is Front End so Vital?

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“BEST IN CLASS”Revenue Cycle Solutions

• 1) Demographic Verification and • 2) Insurance Verification

Web-browser tool for real-time demographic verification, insurance eligibility and/or financial screening (includes pop-up

boxes on registration screen for optimal efficiency)

• 3) Financial Analysis Summary Tool (F.A.S.T.)

Instant patient financial analysis based on credit data; includes charity care analysis, ability to pay and collections bucketing

• 4) Program Eligibility Screening and WorkflowInterview Wizard used to identify potential Medicaid and Charity Care eligibility. Includes automated application completion and

workflow tools to enhance work flow and user experience.

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Screen Shot Workflow

1) Registrar enters patients demographic information into the registration system

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Automatic Pop-up Box with demographic, insurance and/or Financial analysis (includes red flag messages and scripting options)

Automatic Pop-up

Screen Shot Workflow con’t

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Toolbar pop-up can verify patient demographics (name, address, SSN, phone #), insurance eligibility (including Medicaid), and provide a financial pathway (charity and/or ability-to-pay)

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Easy Set-Up and Configuration for desired data in pop-up box

Can opt to include demographic, insurance and/or financial data in pop-up box and can be controlled on a per user basis

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Workflow Improvements and Value Proposition

1) Demographic Verification

Receive demographic validations delivered via a real-time pop-up window sent directly to registrar screen

Reducing returned mail volumes begins with getting the correct address from the start, don’t wait for the patient to leave before you realize you have the wrong address

Red flag alerts on fraud and misinformation can be easily identified at time of registration (fraud equals bad debt)

Use the best data and the most efficient solution to improve registration process

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Workflow Improvements and Value Proposition con’t

2) Electronic Insurance Verification

Stream-line the adjudication process by receiving instant payer information via a real-time pop-up window with necessary insurance information

Empower your registrars by supplying them with instant, accurate insurance information for Medicaid, Medicare and Private insurance patients

Real-time pop-up window with information allows for efficient and user friendly process

Aggressive pricing and a large payer list makes this a great option for any provider 13

Workflow Improvements and Value Proposition con’t

3) Financial Analysis Summary

Instant patient financial analysis including charity care, potential Medicaid and ability to pay for collections bucketing

Empower end-users to more accurately financially bucket self-pay and charity care accounts

Improve front and back end collections by understanding true ability to pay

Decrease financial fraud in charity careIdentify potential Medicaid applicants

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Front End SolutionsPotential Results:

• Up to 30% reduction in returned mail• Decrease in fraud and demographic inaccuracy• Improved insurance adjudication• Increased up-front collections• Improved efficiencies at Registration and

Financial Counseling

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Front End Solutions key I.T. and Operational Features

IT Features• Web-based, instant access for staff• Quick and easy set-up • Real-time response (almost instant)• Option for automation through HL7 interface

(setup time averages 3-6 hours)

Operation Features• Simple to use and train (process supported by

RCI)• Robust and reliable data from Credit Bureaus,

White pages, US Post Office, and Professional database companies

• Customizable screens and messaging• Management reporting

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Overview: Back End Financial Screening, Workflow and Interview Wizard

Best Practice Process:

• Use credit data to predict Charity Care vs. True Self-Pay accounts

• Assign and track accounts with workflow management solution

• Interview uninsured patients for Charity Care and Medicaid benefits with an Interview Wizard

• Populate/Complete applications using automated electronic process

• Report on Charity Care, Medicaid and Collections totals using reporting module vs. manual spreadsheet reporting

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Workflow / Interview WizardKey Features: •Automates the eligibility screening, submission, tracking and management of State Medicaid and hospital specific Charity Care programs

- Assignment Worklists including Case Prioritization- Status Transition of applications- Targeted interview ensures the fastest path to application completion

•Screens the applicant for the complete array of assistance programs for which the applicant may be eligible in a single interview session•Utilizes “QuickScreen” technology to rapidly assess eligibility and allow for 24/7 coverage at all intake points•Electronic Referral process 18

Work listing Accounts

19Manage all Cases and Track Status

Interview Wizard for Charity Care and Potential Medicaid

Rapidly assess eligibility at all intake points20

Interview Wizard for Charity Care and Potential Medicaid con’t

Electronically refer clients to counselors for follow-up 21

Interview Wizard for Charity Care and Potential Medicaid con’t

Electronic folder for all case actions and documents22

Interview Wizard for Charity Care and Potential Medicaid con’t

Data entry screens to capture all categorical and financial information 23

Interview Wizard for Charity Care and Potential Medicaid con’t

Displays potential eligibility for all Household Members 24

Automated Application Process

Pre-populates all forms from screening interview 25

Document Verification Checklist

Guides the user in acquiring and managing supporting documentation 26

Imaging Applet

Acts as an image repository27

Financial Assistance Account Report - 1

Robust tools generate a wide variety of management reports28

Financial Assistance Account Report - 2

Robust tools generate a wide variety of management reports29

Workflow Improvements and Value Proposition

4) Work flow, Interview Wizard and application completion

Minimize bad debt on uninsured accounts by increasing Charity Care and Medicaid conversions

Simplify Charity Care and Potential Medicaid Interview Process with

Don’t bad debt accounts that should be Charity Care or can be approved for Medicaid

Reporting available to extract results

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Why Choose these solutions?

Why are these solutions “Best in Class”?

Easy to setup, easy to use and the most efficient data delivery process These solutions utilize the most accurate credit and insurance data due to strategic partnershipsPricing model provides ‘high reward potential’ with ‘minimal financial risk’

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Why Choose these solutions?High Reward Potential

These solutions directly affect high cost areas in the revenue cycle: returned mail, identify fraud (red flag), insurance adjudication, self-pay collections, charity care and potential Medicaid.

These solutions can greatly assist in improving each of these revenue cycle areas by allowing the end user to be more productive and accurate

Competitive pricing for these solutions allows clients to maximize success in terms of ROI.

Low Risk

Extremely aggressive pricing allows clients to begin utilizing tools with minimal financial risk while still getting the maximum financial return.

Flat fee pricing is offered so clients can run high volumes of accounts and can easily predict monthly/yearly costs while guaranteeing lowest price per transaction.

Low start up costs minimize financial risk for clients who want immediate use for any of the above solutions. 32

RCI Contact InfoSpencer J. CollumRevCure Consulting Inc.President / CEOPhone: 954-347-1555Email: spencer@revcureconsulting.comWebsite: www.revcureconsulting.com

How to Get Started……

Contact RevCure Consulting Inc. to get started; RCI will assist all interested providers to obtain proper contact and contractual information for vendor organizations that support the above

demonstrated solutions.

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