Frequently Asked Questions
What reports do you monitor on an ongoing basis to determine success? +
Transaction totals, including total gross charges with anticipated collections, total cash collections and total adjustments – often grouped by location and/or provider.
Compile transactional data to analyze month over month trends.
Aging Reports to analyze patient and insurance aged receivables across standard aging buckets and to measure AR Days.
Monthly payer mix report to analyze utilization by carrier.
Reimbursement Analysis Report to analyze net and gross reimbursement by charge code and by funding source.
Insurance Discrepancy report to monitor the occurrence of underpayments by funding sources.
Claims Submission Analysis to evaluate and monitor rate of first pass clean claims and denial rates and categories.
Elapsed Time from DOS to Billed to evaluate and monitor the average number of days between date of service, charge capture and claim submission.
Incoming Call Log to evaluate and monitor number of answered and missed calls and how many calls were transferred to voicemail.
Is there an assigned customer service representative or account manager specifically assigned to our account to monitor benchmarks and interact with our management team? +
Yes, each client has a dedicated Account Coordinator, and customer service team. Each team also has a certified professional coder. Additionally, each of our Coordinators receives weekly and monthly mentoring by our Leadership Team to encourage ongoing growth and accountability in these areas:
• Level of Impact
How do you handle patient statements? +
We generate detailed, line item statements each business day – statements are on a 25-day cycle.
Statements include the service code, rate billed, any payments and adjustments applied, and outstanding line item balance.
We give clients two statement options:
1). Traditional line item statements generated electronically through our preferred integrated clearinghouse, Change Healthcare. Change Healthcare prints and mails statements via paper, including credit card payment remit stub and return envelope.
2). eStatements via text, email or portal access through our preferred integrated API vendor, Inbox Health. More information on Inbox Health here: https://inboxhealth.com/
Prior to releasing statements, we scrub for any errors and unapplied payments.
We offer the ability to assess finance charges in accordance with state laws.
What is your specific process for providing a superior client experience to clients and their teams? +
We start with over-communicating our company mission and values to our employees, from interview to onboarding and beyond.
We Show Up: We intentionally engage in authentic and impactful ways. Intentional means we seek out and interact on purpose. Engage means we show up with our full selves. Authentic means we are real, honest and vulnerable. Impactful means we understand the value of interactions and how they move connection, service and innovation forward.
We partner with new team members during the onboarding process and monitor calls and communications to ensure a consistent experience across our teams.
We provide candid and real time feedback, from a front-line level all the way up to the Leadership team, if we hear someone interacting in a way that is not in alignment with our Core Values and Behaviors.
We provide outstanding compensation and vacation time… and encourage people to use it. People who feel invested in, and treasured, treat others around them the same way.
We regularly celebrate and recognize customer service victories and conduct “post-mortems” of challenging interactions.
What dashboards do you have or KPI’s do you provide to clients? +
We offer several dashboards and options for KPI reporting. We monitor the following traditional revenue cycle management KPI’s and report on a monthly basis via our Monthly Financial Summary. We also monitor these metrics weekly on a team by team basis internally.
• Days in AR
• Percentage of AR over 90 Days
• Dollar amount of AR over 90 Days
• Net Reimbursement Rate, Last 12 Months and Last Year
• Gross Reimbursement Rate, Last 12 Months and Last Year
• Average Collections Per Encounter
We also monitor what we call lead measures, that influence our KPI’s (or lag measures). These are monitored by our teams on a weekly basis and can be shared with our clients either via email or via the Reporting Module in our RCM software.
• Average time elapsed between DOS and Claim Billed
• Denial Rate
• Average Age of Denial
• Average Daily Charges (Annualized)
We offer full client access to our Reporting Module, which allows real time access and utilization of Dashboards or Custom Reporting. We customize dashboards per client.
Can we customize reporting package? +
Yes, we offer customized report summaries, access to ad-hoc reporting and can create access for ODBC. In addition, we provide training to key stakeholders to generate and access reports in real time, as needed.
Do you use certified professional coders? +
Yes, we have a certified professional coder (CPC) assigned to each functional team.
Do you use a lockbox, ERA Direct Deposit or do we deposit insurance checks and scan? +
We have clients that use lockboxes, and we have clients that deposit checks and upload EOB and check reconciliation information into our RCM platform.
We assist all clients with EFT and ERA enrollment, to minimize paper checks and explanation of benefits. We currently average 90% or higher EFT/ERA enrollment rate for our clients.
Do you perform pre-authorization services? +
We currently offer the ability to coordinate and execute prior authorizations for Dermatology and Autism Services clients.
What are your standard billing rates? +
Our standard rate varies slightly depending on scope of service, scope of practice and volume. Our standard rate ranges from 4-6%.
For new client implementations, do you expect any down time in collections? +
If contract and go live date is executed along our standard implementation timeline, we have not historically experienced collection down time for any of our clients.