RAC Audit Management
Stay on top of your RAC and other audits with Audit-TRAX, a workflow management tool that eases your administrative burden and provides facility operational enhancements and customized outcome reports for managing all of your audits from beginning to end.
340B Contract Pharmacy Services
SUNRx is based in Bensalem, Pennsylvania and provides automated solutions that assist organizations in managing 340B Contract Pharmacy Services. SUNRx’s 340B Simplified program creates opportunities for all pharmacy types to participate in qualified hospitals’ programs. The Simplified program includes a fully automated system that manages the flow of inventory, information, and payments between qualified hospitals, pharmacies, wholesalers, and third-party payers. Additionally, SUNRx has automated reporting and auditing, and ensures hospitals and patients pay the lowest price for medications.
Click here to download 340B Savings and Revenue Opportunity brochure.
Denial, Review and Appeal Management
The Florida Hospital Association Management Corporation Denials Management Services (FHAMC DMS) has efficiently and successfully reviewed and appealed denial cases for Florida Hospitals in which a vast majority of the appealed cases were recovered. FHAMC has won an impressive 100% of the recovery appeals taken to an administrative law judge and most appeals result in a favorable determination at the MAC/QIC levels.
FHAMC DMS has a team of Physician Advisors, UR/Case Managers, AHIMA Certified Coding Specialist with hospital coding experience, and legal advisors to help your hospital to efficiently manage your response to all payment denials.
Click here to download Denial Management Services brochure.
Coding and Transcription
DocuVoice LLC is a marketing/consulting company that specializes in outsourced coding/transcription solutions to address healthcare needs. Its solutions also include ICD-10 assessment/training services, encoder software and Physician conducted chart reviews. The DocuVoice team works closely with you to design a custom program to address any of these areas by identifying your current situation at no charge.
If an opportunity exists for DocuVoice to offer solutions, they have a number of partner companies that specialize in providing outstanding solutions to address each of these areas. Ongoing, DocuVoice will continually monitor every project to make sure that the facility is delivered the highest quality and performance of any identified area of need.
Revenue Cycle Management Tools
Revenue Benchmarking for Hospitals: PDS is an on-line database of paid claims, with data from all patients and all payers. Hospitals use this market intelligence for strategic planning, business development, contract negotiation, and more. Many PDS users are adding tens of thousands of dollars, and sometimes more, to their bottom line. Find out how you can too.
Commerce Bank’s ControlPay® AP Payments allows you to pay invoices electronically through the Visa® Network. You will reduce check writing costs and earn monthly revenue share based on an aggregate volume from all of the Arkansas hospitals that participate in this program.
Key benefits include:
- No financial investment or cost to participating hospital
- Revenue share is paid monthly
- Ongoing recruitment of hospital specific vendor participation to increase effectiveness and revenue back to the hospital
- Your vendors benefit with guaranteed funds and reduced risk for check fraud
Commerce’s team of dedicated enrollers contact your vendors, review the variety of payment options available and enroll them in the program. The more vendors who are enrolled in the program, the higher your volume tier will be, contributing to a greater revenue share.
Commerce also offers the next generation of payment automation, ControlPay® EIPP (Electronic Invoice Presentment and Payment), allowing commercial clients to automate their invoice receipt, approval and payment processes. This solution offers three levels of flexibility:
- Full Process and Payment – Facilitates invoice automation with data detail extraction; supports electronic work flow approval; executes payments via Visa®, ACH, Wire and Check
- Invoice Automation and Payment – Facilitates invoice automation with data detail extraction; forwards electronic invoice data file to Buyer’s ERP for approval; executes payments via Visa®, ACH, Wire and Check
- Payment Only – Executes payments via Visa®, ACH, Wire and Check
With both of these programs you will also experience our dedicated in-house support teams who help you meet your program goals, implement best practices, maximize efficiencies and generate revenue.
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Accounts Receivable Management
nTelagent’s fully integrated accounts receivable solution revolutionizes how you interact with patients at the point of service by guiding patient access staff through each patient encounter via real-time, customized scripts. From insurance verification to payment processing, registration is fast, simple and accurate for all patients: insured, uninsured and those qualifying for financial assistance. In minutes, registrars using nTelagent validate the patient’s address, verify insurance, process medical necessity (when appropriate), determine the approved charge for the patient based on the service provider’s contracts, and follow online scripts for discounts, payment terms and patient collections.
Key benefits of nTelagent’s completely integrated system include:
- Increase cash, decrease bad debt and AR days
- Reduce denials, returned mail and collection fees
- ID capacity to pay and financial assistance
- Set up payment terms for increased and ongoing AR collection
- Improve registrar workflow and patient satisfaction
- Harness real-time reporting for monitoring and accountability
- Move revenue cycle upfront – pre-registration and POS
- Spend a fraction of the cost of purchasing disparate systems