RCM Solutions: Your Rx for Healthy Patients and Healthy Profits

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In the quest to save lives and keep patients healthy, the success of healthcare organizations can be derailed for reasons that have nothing to do with quality of care. Navigating the maze of different payer rules and codes, rejected insurance claims, lengthy time lags to collect payments from payers and other collection headaches all can take a heavy toll on your bottom line.

So how do you keep your organization in top-notch fiscal fitness? By focusing on what you do best, caring for patients, while outsourcing medical revenue cycle management to experts in the industry such as Hansei Solutions. We take full-service revenue cycle management to a brand-new level with our proprietary business intelligence platform that leverages the most robust historical datasets and integrates with electronic medical records to project revenue and increase your revenue cycle efficiencies.

We are more than just a billing company, we are strategic partners for your growth. Our technology and predictive analytics can elevate your business, clearly and efficiently and help you make more informed business decisions. In the ever-changing healthcare industry landscape, our data and technology stay up to date on coding, compliance and insurance information so you don’t have to.

Simply put, we’re the aspirin that gets rid of your financial headaches.

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How do revenue cycle management services work?

The medical revenue cycle management process begins when a patient calls your office to make an appointment. The process ends when you’ve been paid for all insurance claims and patient co-pays and deductibles.

Sounds simple, doesn’t it? That’s far from the truth. The process is like an obstacle course with one hurdle right after another that’s enough to exhaust anyone managing a healthcare practice. Easy-to-make errors in front-end tasks, such as eligibility verification, registration and preauthorization, often result in claim denials. Before you know it, your insurance claims hit the spin cycle, going back and forth between you and the payer for months until all issues are resolved.

There’s got to be an easier way, right? There is — by improving your cashflow and compliance with Hansei Solutions’ full suite of revenue management services. Here’s a snapshot view:

Revenue Management Services

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  • Verification of benefits (VOB): Gaining information about a patient’s insurance coverage and eligibility to predict the insurance reimbursement rate for services.
  • Utilization review (UR): Evaluating a patient’s care plan to determine the medical necessity of certain levels of care and length of treatment based on insurance company criteria.
  • Medical coding: Translating important medical information into simple codes for documenting medical records and informing accurate medical billing.
  • Claim submission: Determining the healthcare provider’s reimbursement amount after the insurance company clears all dues.
  • Accounts receivable (AR) follow-up: Providing due diligence to ensure a healthcare organization has a way to recover overdue payer reimbursements as well as guide your organization to collect what is owed to you by the patient.
  • Denial and appeal management: Examining denied claims and partial payments, reopening them to receive maximum insurance reimbursement.
  • Payment posting: Capturing outstanding revenue by analyzing all previously billed charges and remaining claims, posting all funds that have come in from insurance, and reconciling with your internal financial source to ensure all monies are allocated accordingly.
  • Patient statements: Creating medical bills containing information on all outstanding payments for patients.
  • Reporting financial revenue and accruals: Delivering comprehensive aged receivables reports that reveal how the revenue cycle management process impacts a business on all levels.

How can my business benefit from medical revenue cycle management?

“No matter your business stage, we offer a full suite of revenue management solutions to tackle challenges and seize opportunities,” says Hansei Solutions Chief Executive Officer and Founder, Erin Burke. “From everyday business matters such as estimating a patient’s out-of-pocket costs and monitoring medical billing processes to using advanced technologies to arm your organization with predictive analytics and compliance updates, we help you get paid faster, project revenue and make more informed business decisions.”

“We believe it takes dedication, continuous innovation and responsiveness to form bonds and ultimately build your business,” she adds. “We’re in it for the long term.”

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Ready to focus on providing healthcare? Let us lighten your load.

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We’re here to address your pain points and create growth opportunities for your organization. We’re passionate about what we do, and it shows in every interaction. Learn what makes us tick and schedule a demo today.

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