Revenue Assurance Services for Hospitals

An efficient revenue assurance program is critical to sustain the financial health of Healthcare Organizations. We deliver accurate and compliant revenue capture, improve clean claims submission, and process payments efficiently. Our proprietary technology platforms help you realise the reimbursements due to you and minimise risks.

Charge capture and Clinical Revenue Integrity

Access Healthcare strives to create a compliant revenue-generating process by providing comprehensive capture and clinical revenue integrity solutions.

Service inclusions

• Development of Charge Description Master (CDM), charge capture, and audit services

• Specialty-focused charge capture and coding team members for outpatient services 

• DRG coding specialists for inpatient services

• Focus on identification of missed charges

Benefits

• Review of fee schedules and alignment of charge description masters to payer standards

• Improved accuracy of charge capture and coding services

• Clinical Document Improvement by involving and educating clinicians

• Identification of revenue leakage areas. 

• Improved TAT and quality

• Improved ability to manage clinical denials and shift focus to denial prevention

Claims Submission - rejects management and Work edits

Over 10% of healthcare claims have quality and reconciliation issues addressed through a rejection management process.  

Service Inclusions

Access Healthcare's claims submission services include:

• Clearinghouse edit management

• Handling of rejections

• Electronic claims submission via a clearinghouse

• Understanding of top issues by payer, state, and medical specialty

Benefits

• Reduce costs by 30-50% through our global delivery model

• Improve first pass rates and avoid denials by addressing clearinghouse rejects

• Improve Days in A/R by reducing denials and accelerating cashflow
  

Payment Posting

At Access Healthcare, we understand that payment processing is crucial for reconciling patient accounts and enables a clear view of the A/R.  We process the following:

Service Inclusions

• Patient Payments. We reconcile the point of service payments made by patients for co-pays, deductibles, or non-covered services. We also process any self-pay payments at the same time. 

• Insurance Payments. We process remittances received from insurance companies electronically as Electronic Remittance advice (ERAs) or as paper EoBs. Our team utilizes our proprietary echopay platform to run ERA batches and process exceptions. Paper EoBs are processed using OCR capabilities embedded within the echopay platform.

• Denials Posting.  We post denials to keep the A/R reports current and determine final responsibility for payments. 

Benefits:

• Efficient Payment processing with lower operational costs

• Assured delivery with improved payment processing accuracy and guaranteed turnaround time

• Process automation through echopay - EOB Processing tool