Author: EM Squared

Contract Management Tool

Posted on by EM Squared
Revenue Technology

ParaRev’s Contract Management Tool improves your revenue cycle by identifying the primary cause of denials, developing a work improvement process, and identifying short paid claims. With it you can manage, evaluate, and optimize reimbursement to achieve the required returns with access to our web-based tool for coding, reimbursement, and compliance.

Three components to the process:

  1. The Payer Scorecard – a high level snapshot of denials from your top ten payers
    • ParaRev will load 835 remittance files at both the claim level and the line item level for the ParaRev Data Editor to identify and summarize denials, and settle the claims under the contract term details loaded in the PDE.
  2. Remit Reconciliation – analysis of payments reconciled against contract rate sheet
    • Users can choose to examine the remittance denial codes within one or more individual remittances, or among all remittances within a date range.  This review can be done within the tool, or a package of reports can be exported for analysis.
  3. Pro Forma Analysis – comparison of existing terms to proposed terms to analyze the impact
    • Analysis can be performed on contracts under negotiation by comparing the proposed terms against the current terms, displaying the impact based on the remits received.

Within each of the ParaRev standard patient types, the contract terms are defined, if the service is reimbursed based on a DRG, APC, fee schedule, ASC level or per diem, there is no relationship between pricing and reimbursement. The Pricing tab will only attribute additional net variable revenue to those contracts which have been specifically loaded into the Contracts tab and the reimbursement is based on a percentage of charges.  

ParaRev’s Contract Settlement models can accommodate a variety of methodologies including MSDRG, APDRG, EAPG, OHAS, etc. The solution also incorporates adjustments due to Lessor Of, Stop Loss, and Claim Cap payer contract terms.  The model identifies accounts/charges that are impacted by these adjustments and determines the net revenue impact of pricing changes.

RCM in 2021: Roadmap to a strong financial comeback

Posted on by EM Squared

Throughout 2020, the COVID-19 pandemic threw hospitals an array of unprecedented challenges, but 2021 is the ultimate opportunity for your organization to bounce back.

Webinar title screen

The changing environments, staffing shortages and new regulations weren’t easy for any organization, but you can ensure the best possible financial outcomes in 2021 by:

  • Optimizing staff efficiency
  • Staying on top of current inventory changes
  • Identifying where and how to maximize revenue

How prepared is your organization to bounce back from the COVID-19 financial challenges?
Download this recorded webinar and listen to Daniel Low, Director of Operations at Healthcare Financial Resources, detail how to implement an action plan that will help your organization improve its bottom line.

Download the webinar replay by completing the form below:

Price transparency – clarifying the unknown

Posted on by EM Squared

Today’s healthcare industry is presenting new challenges for providers due to the high-deductible plans that are popular with patients obtaining coverage through the State and Federal marketplaces.

Patients are now faced with an increased responsibility in healthcare costs, forcing patients to “shop” a service, which creates a need for meaningful and accessible price transparency. In turn, CMS and State governments are releasing guidelines to mandate price transparency for hospitals.

Navigating these regulations and putting them into action is a growing concern as the Jan. 1, 2021 deadline approaches. This presentation focuses on putting together the pieces of these guidelines and helping hospitals create solutions to achieve price transparency through rational pricing methodologies and easy-to-use patient cost estimates.

Our presenters will break down the CMS regulations, discuss the demand for rational pricing methodologies as a major component to transparency, and demonstrate how the solution would look to the patient.

Objectives:

  • Describe powerful pricing strategies to resolve transparency concerns
  • Analyze the CMS Price Transparency guidelines as they are written today
  • Create actionable steps to price transparency

Meeting the challenges of pricing transparency demands a systematic approach grounded in empirical evidence and a capable staff implementing proven solutions. ParaRev can help you refine your pricing to improve revenue capture and strengthen margins while remaining competitive in your market.

Contact us today to learn more about how we can help your organization prepare for the transparency transformation ahead.

Download the webinar replay by completing the form below:

Staying Financially Healthy

Posted on by EM Squared

Hospitals Must Protect Revenue Cycle Capabilities to Limit COVID-19’s Financial Fallout

Any initial effort to meet the anticipated financial impact of the COVID-19 pandemic must start with:

  1. Revising financial performance targets, cash flow projections, and operational plans
  2. Determine operational issues that can occur related to the COVID-19 outbreak that could negatively impact cash flow and overall performance

Trusted and timely third-party assistance

Whether hospitals and other providers elect to shift revenue cycle staff to the home setting or not, consider partnering with a trusted third-party capable of taking over elements of the revenue cycle for the duration of the crisis. Healthcare Financial Resources provides a full range of outsourced AR follow-up services, including aging claims resolution, denial management and bad debt mitigation to help ensure claims are clean and paid the first time around to mitigate any delays. More than 98% of the company’s workforce is now deployed remotely and all of ParaRev’s remote work processes are HITRUST CSF®-certified.

Download the whitepaper by completing the form below:

CMS Price Transparency Mandate Is Here: 4 Critical Tasks for Achieving Compliance

Posted on by EM Squared

Price transparency is here. Is your hospital in compliance?

whitepaper cover page

With the federal government’s price transparency regulations recently strengthened to include stiffer penalties, hospitals and health systems must move quickly to ensure full compliance with the spirit and letter of the landmark regulation.

Providers must therefore address the following four tasks to meet the regulatory mandates:
Step 1: Price Optimization
Step 2: CMS Requirement 1 Compliance
Step 3: CMS Requirement 2 Compliance
Step 4: The Patient Interface

An End-to-End Solution

Unlike other companies, ParaRev has developed a comprehensive solution that helps hospitals rapidly execute all four steps necessary to comply with the transparency rule.

Time is of the essence, so don’t delay. Contact ParaRev today to learn how we can help you achieve these critical objectives.

Download the whitepaper by completing the form below:

The future of RCM – How technology can bring an end to reimbursement uncertainty

Posted on by EM Squared

Improve margins and the patient experience through high PFS performance

Financial distress among American hospitals is on the rise. At least 30 hospitals entered bankruptcy in 2019, according to Bloomberg. Additionally, 2019 saw a record number of rural hospital closures with nearly 20 hospitals closing their doors.

The difficult financial circumstances faced by many of the nation’s hospitals and health systems are partly driven by an uncertain reimbursement environment. This webinar will dive into best practices for accelerating collections and improving the patient experience through better revenue cycle management.

Key points:

  • How to deploy powerful pricing strategies to resolve reimbursement and transparency concerns
  • How to apply effective use of robotic process automation to drive touch reduction
  • How to utilize trending to reduce and overturn denials
  • How to maximize revenue from aged insurance accounts receivable

ParaRev is a leader in accounts receivable recovery and resolution. The company works as a virtual extension of your hospital’s central billing office to help resolve and collect more of your insurance accounts receivables faster while improving operating margins through a seamless partnership with your internal team.

Download the webinar replay by completing the form below:

Transforming Bad Debt into Revenue

Posted on by EM Squared

4 Non-traditional approaches to mitigating write-offs and improving hospital collections

Multiple factors continue to fuel an increase in hospital bad debt, squeezing already-thin hospital margins and undermining financial stability.

Learn how the following four non-conventional approaches can reduce write-offs and improve collections:

  1. Zeroing in on denial management
  2. Price transparency capabilities
  3. New technological tools
  4. Pre write-off AR management

How can we help?

ParaRev specializes in AR recovery and resolution. We work as a virtual extension of your hospital central billing office to help you resolve and collect more of your insurance accounts receivable faster and help improve operating margins through a seamless and collaborative partnership with your internal team.

Download the whitepaper by completing the form below:

 

Top 3 Hospital Departments with High Denial Volume

Posted on by EM Squared

Gaining control over denials to reduce chronic revenue loss and costly remediation requires accurate information about where, when and why denials are occurring. ParaRev has identified the top three departments where denials are the most prevalent. Download our whitepaper to learn how to decrease denials and improve margins.

We can help you

ParaRev can help you overcome the challenges of hospital pricing and revenue cycle management with a systematic approach grounded in empirical evidence and a capable staff implementing proven solutions. Download our whitepaper discussing the top three hospital departments with high denial volume.

Download the whitepaper by completing the form below:

3 Ways to Accelerate your Financial Transformation: Take your Pricing and Revenue Cycle Management to the Next Level

Posted on by EM Squared

Business models in healthcare are evolving rapidly. Gone are the days when hospital pricing strategies were isolated from competitive pressure and facilities could flourish with less-than-optimal revenue cycle policies and procedures.

To succeed today, hospitals must invest in new capabilities that can help them achieve previously unobtainable levels of precision, functionality and transparency across their pricing and revenue cycle domains.

We can help you

ParaRev can help you overcome the challenges of hospital pricing and revenue cycle management with a systematic approach grounded in empirical evidence and a capable staff implementing proven solutions. Download our whitepaper discussing the three ways to accelerate your financial transformation for improved revenue capture and better margins.

Download the whitepaper by completing the form below:

What You Don’t Know CAN Hurt You – A deep dive into how using intelligent automation can revolutionize your AR recovery

Posted on by EM Squared

Increase AR Efficiency and Accuracy with Intelligent Automation

With insurance denials and payment delays at an all-time high, many hospital systems are seeking to use advanced automation technologies to increase efficiency for expedited insurance recovery. This webinar will present real-world examples featuring a how-to guide on getting started with implementing intelligent automation and robotic process automation (RPA) to accelerate AR recovery.

Key takeaways from the presentation include an understanding of:

  • Strategies to select optimal processes to automate
  • The steps to get started to implement intelligent automation and RPA
  • Using intelligent automation and RPA to generate appeals and adjustments without human intervention

ParaRev is a leader in accounts receivable recovery and resolution. The company works as a virtual extension of your hospital’s central billing office to help resolve and collect more of your insurance accounts receivables faster while improving operating margins through a seamless partnership with your internal team.

Download the webinar replay by completing the form below:
Secured By miniOrange