Revenue360 Insurance Code Solution

Hospital Insurance Code SolutionPatient insurance information gathered at the point of registration must be accurate to ensure prompt payment of claims. As the payer market becomes more complex with compliance issues and regulatory/contractual rules, consistent accuracy throughout the registration process becomes more challenging to the registrar.

Revenue360® Insurance Code Solution prevents registration errors before they are even entered into the system. Proactively and intelligently guiding and prompting registrars to capture and sequence the correct insurance information with every registration, Revenue360® Insurance Code Solution reduces denied claims, improving your revenue cycle. No need to concentrate on error identification and rework on the back-end after the point of service. No more delayed reimbursements or write-offs. Revenue360® Insurance Code Solution allows your staff to accurately register the patient every time by reacting consistently to the prompts and guidelines that match your organization’s business rules. The result? Lower AR days, increased cash-flow, and improved patient and staff satisfaction.

Five Ways to Use Intelligent Guidance

1) Intelligent Real-Time Alerts – Alerts the registrar to skip to a different stage of the process or change the sequence of the workflow. Easily administered rules drive these actions.

2) Intelligent Real-Time Prompts – Anticipate where errors are likely to occur and have prompts pop up with instructions to eliminate the potential error.

3) Intelligent Format Checks – Catch format errors and direct the registrar on how to correct them, thereby eliminating up to 90% of all errors due to careless typos that may compromise an entire registration.

4) Automated Intelligent Scripts – At selected times during registration, Intelligent Guidance can pop up a scripted response related to any situation, compliance, policy or patient.

5) Intelligent Registrar Guides – Guides containing an easy-to-understand tree of questions and answers can pop up at any point in the registration process to lead the registrar through a deductive process that results in an automated action.

There are many other ways you may choose to add Intelligent Guidance to your offerings to optimize and transform the healthcare revenue cycle for your customers.

Insurance Code Solution Advantages for:

Being a hospital Revenue Cycle Manager means taking steps to assure that you get paid for your services in a timely fashion. How to achieve this? Eligibility verification and pre-authorization on the front end helps to prevent claim denials on the back end. Getting the right numbers for insurance codes and patient demographics helps registration accuracy. Evaluating the patient’s ability to pay, determining their eligibility for Medicaid and charity care, providing them the best estimates of financial responsibility, and payment processing helps front end collections. Revenue360® has a suite of tools that you can tailor to your needs to get your balance to zero.

Changes and updates to internal registration processes as well as new payer information happen frequently. It is your job to train your staff on these updates. However, these changes are difficult to remember and apply to each registration. How can you ensure that your staff flawlessly registers each patient correctly every time?

Revenue360® Insurance Code Solution module simplifies the registration process and improves accuracy by guiding and prompting the registrar to insert the correct insurance plan code every time. Using scripting technology, you can quickly update staff on the frequent changes, eliminating costly errors and rework on the back-end. Training is decreased and registrar productivity and morale improves.

Changes happen frequently to internal hospital procedures as well as health plans that affect how you register a patient.  You are expected to remember it all, an impossible task. Revenue360 Insurance Code Solution module simplifies your registration process, ensuring complete accuracy with each registration.  Guiding and prompting you, Revenue360 Insurance Code Solution module allows you to insert the correct insurance plan code every time. Capturing and managing registration rules, Revenue360 Insurance Code Solution module prompts you with scripts to ensure registration consistency allowing you to navigate through the complex registration process quickly and efficiently using your own payer mnemonics.

Related Blog Posts:

Mania Continues: Insurance and Hospital Mergers

Evidence from industry publications, news, and thought leaders indicate that the Affordable Care Act continues to cause merger upheaval in the insurance and hospital industries. Is this merger mania what’s best for patients, and hospital revenue cycle results?

read more

Health Insurance Company “Mega-Mergers” Continue

The acquisition of market power among healthcare insurance continues in 2016. In fact, the consolidation momentum is growing so strong, that insurers are now more likely to complete dubious mergers and cite government pressure as their justification. How are hospitals and patients dealing with these changes, and what will be the end result of hospitals that now seek to offer their own insurance plans?

read more

Healthcare Insurance Mergers in 2016

When we last took a look at healthcare insurance mergers in November, we noted that healthcare costs continue to increase, and both deductibles and insurance premiums are rising significantly. We also saw some regulators resisting payer mega mergers (in addition to the AMA). Now it seems that big insurance continues to prosper, but state regulators may deal some serious blows to further merger ambitions, as the some insurers look at withdrawing from the exchange markets.

read more

Most Common RCM Pain Points and How to Overcome Them

Revenue Cycle Management consultant and former hospital CFO, Milton Wilhite, shares the recurring pain points that hospitals experience in the revenue cycle management process. This article highlights items from his recent interview and explores potential solutions to the RCM challenges Wilhite presented.

read more

Patient Registration Process and Effective Use of RCM Tools

Recently we had the privilege to interview a registrar at a community hospital about her daily patient access routines. This is the first post in a series where we will explore how she uses Revenue Cycle Management (RCM) tools in her everyday work. We will also identify potential gaps in the registration process that could be remedied with integrated revenue cycle software solutions. It was a busy day in the registration department at a community hospital, and Amanda, a patient access staff member, was registering one patient after another. Working on only one cup of coffee she was feeling… (learn more about RCM software and the registration process)

read more

Software Solutions for Hospital Bad Debt

Hospital Internal Bad Debt Reduction Hospital bad debt has been a hot topic among news outlets in the last few months. One case in point was the publication in April of Wyoming Medical Center's $38.1 million in uncompensated care, occurring during first eight months...

read more