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Managing Revenue as an Out-of-Network Provider

Managing Revenue as an Out-of-Network Provider

Out-of-network providers have unique flexibility in terms of treatment and payment options, but the lack of a predictable income stream can bring some uncertainty whether reimbursement from the payer will be received. Several out-of-network providers have used unique market positioning to enter into contract arrangements that forgo constant payment negotiation.

Improving Billing and Collection Realization Rates with Proper Revenue Cycle Support

Improving Billing and Collection Realization Rates with Proper Revenue Cycle Support

Claims are denied for valid reasons: missing information, incorrect patient data, duplicate claims submission, services not being covered by the payors, or beneficiaries not being eligible for services. There are many benefits to using a Revenue Cycle Management (RCM) partner who will help focus on collecting, organizing, and ensuring data accuracy.

How to Turn a SUD Facility into a Thriving Mental Health Program

How to Turn a SUD Facility into a Thriving Mental Health Program

Offering more services translates into more patients staying within the facility and a subsequent expansion of profit margins through more beds filled and an increase in charge volumes. A facility that can benefit tremendously from expanded services is the Substance Use Disorder (SUD) facility. There are many decisions required to be successful.

Utilization Review and Addiction Therapy Modalities

Utilization Review and Addiction Therapy Modalities

Utilization Review (UR) is critical to manage quality and cost of care. A legal requirement for participation in federal healthcare programs, it’s also crucial for preventing claim denials, keeping track of coverage rules/regulations, and preventing the misuse, or overutilization, of services. A revenue cycle management company can make a difference in reimbursement rates.

Revenue Cycle Management

Revenue Cycle Management

Outsourcing has become a critical part of providers’ strategies to achieve cost competitiveness and increased effectiveness in administrative activities. Many practices have used a revenue cycle management partner to bring into their organization the expertise and critical information systems they would not be able to create for themselves through in-sourcing.

Leveraging Low-Pay Recovery Efforts to Recover Underpayments

Leveraging Low-Pay Recovery Efforts to Recover Underpayments

Payers often adjudicate claims below the providers’ contract rate agreements or underpay claims when they don’t have a contracted agreement with the provider. Judgments by payers can lead to lost revenue for the provider. Partnering with a revenue cycle management company can recover additional payments by implementing low-pay recovery processes.

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