Revenue Cycle Enhancement
Improve your financial performance
In today’s healthcare world, medical excellence alone won’t make your organization successful. Your team’s best efforts can be undermined by the staggering complexity of insurance and government payor requirements, claims processing and a payment system that frustrates patients and leaks cash. Adept Health can help you transform your revenue cycle services. We have a proven track record in improving financial performance through regulatory compliance, utilization review, charge capture, analytics and all other aspects of the revenue cycle. We want to share our success with you.
Utilization review, pre-service and patient access
Numerous regulations cover how government and commercial payors will treat a claim, and it’s vital to place all patients in the right service. Adept Health understands that and we can help you achieve superior first-pass payment rates and reduce claim denials and rebilling.
Revenue integrity, chargemaster and health information management (HIM)
Converting medical information into financial information – and adhering to strict standards of regulatory compliance – is one of the most complicated jobs of any health system. Adept Health has a track record of success in correctly capturing medical charges, and we can help you ensure you get paid for the services you provide.
What we do:
- Interview your team and supply your leaders with industry benchmark data and Adept Health’s own data
- Provide recommendations for scheduling, insurance verification, authorization, point-of-service collections, price estimation and financial counseling
- Identify potential Medicare compliance risks
- Review write-offs to identify opportunities for improved financial performance
- Evaluate your utilization review plan or help you develop one
- Conduct labor analysis to determine staffing needs
- Provide contract physician advisor services for inpatient/observation patient status changes
- Assessment of your current charge capture, charge integrity and payor compliance processes, as well as guidance in the development of a regulatory compliance and education program.
- Audits of your chargemaster to identify outdated Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) code assignments and descriptions, mismatches in uniform billing revenue code and CPT/HCPCS codes and more.
- A review of each department’s revenue and usage date to determine if there are potential charging issues, as well as an assessment of change control processes.
- Evaluation of your health information management system, supplying Adept Health and industry benchmark data so you can improve processes, staffing, coding and release of information. We’ll assist with insourcing or outsourcing of HIM functions.
What we deliver
- An analysis of key performance indicators, including discharged not final billed (DNFB), billing and claims transmission, denial management, account follow-up activity, self-pay process, cash posting, payment compliance, vendor strategies. We’ll show you which areas to target for improvement.
- An action plan will include staffing analysis, productivity and quality measures, cash acceleration plans, self-pay/bad-debt strategies, denial root cause analytics, credit balance review, aging analysis and cost to collect.
- A review of your current dashboards, scorecards and reporting tools.