White Papers
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
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.
SIU Audits and their Impact on Small Providers
Audits and recovery efforts are common in the revenue cycle. Financial incentives for payers to pursue recovery may be substantial. For the smaller provider, it can have a significant effect. Dependent on the payer type and the objective(s), the name of the audit can vary. For private payers, Special Investigation Units (SIUs) are common.