Through its Global Corporate Payment Group, American Express offers a suite of payments solutions that helps hospitals streamline payment process and transform them into opportunities for savings. Working with American Express can help hospitals optimize working capital; increase days cash on hand; achieve their goals around savings, control and efficiency; and strengthen relationships with suppliers.
Apex Revenue Technologies is a national provider of technology-based solutions and services that enable healthcare providers to improve revenue cycle results while also strengthening relationships with patients. We are inspired by the understanding that traditional, static billing and payment solutions are not achieving the results that healthcare providers need to resolve patient financial challenges. Apex Fits the Payment to the Patient® through targeted communication. Based on our unique insights into patient payment behavior, we help healthcare providers increase revenue, decrease costs, and deliver a more personalized patient experience.
ClearBalance® partners with health systems to provide consumer-friendly payment plans so patients can affordably pay their cost of care. We maintain the industry’s highest patient loan repayment rate and our program is proven to demonstrate patient loyalty. We have serviced more than 4.5 million patient accounts. Our client roster includes 800-plus hospitals and health system facilities nationwide, ranging from multi-state IDNs to state university health systems, regional health networks, and single-state, single-location midsize health systems. The ClearBalance ROI Value Model™, Peer Reviewed by HFMA, establishes nationally recognized patient loan program performance standards to benefit health systems and their patients. ClearBalance.org.
CliftonLarsonAllen is a professional services firm that believes in the pursuit of the Triple Aim and in the organizations across the country that are transforming care delivery to achieve it. Enabling your success means a better world for all of us, but now more than ever a number of operational, regulatory, and environmental challenges stand between you and success. We believe we can help! Our industry specialized practitioners bring practical knowledge and capabilities to serve you more completely. Our insightful ideas, innovative approaches, and deep commitment to client service will aid your organization in achieving its goals and building the better organization you envision.
CrossChx is building operational artificial intelligence, which empowers humans to achieve more than ever before. Olive, the company’s AI solution, acts as the intelligent router between systems and data by automating repetitive, high volume tasks and workflows providing true interoperability for organizations. CrossChx has a mission to scale humans by allowing AI to operate existing systems and letting it do what machines do best.
FMA Alliance (FMA) is a Limited Partnership located at 12339 Cutten Rd. Houston, TX 77066. Founded in 1983, FMA is a national collection agency headquartered in Houston, Texas. FMA is privately owned by its two original founders, Jeff Spiegelhauer and Doyle Burkett and is not beholden to outside investment. FMA is debt-free, financially sound, and has unused lines of credit that can be used to scale up to project demands, and therefore presents a very low execution risk for its healthcare clients.
The healthcare revenue cycle has grown increasingly complex. As a result, hospital financial leaders across the nation rely more and more on vendors – technologies and outsourcers, to help get it all done. The new challenge is finding the time to manage these relationships to ensure that anticipated outcomes are achieved.
That’s what Healthfuse does, and it’s all we do. We help hospitals better source and manage their revenue cycle vendors to reduce costs, increase performance, ensure proper performance visibility, and correct issues. We do this by providing tools, analytics, proven research, and advisory services.
Over the last five years, our hospital network has achieved over $200 million in bottom-line improvement through our program. These are dollars that drop right to the bottom line, and we only get compensated once they do.
HealthRise is a revenue cycle management consulting firm passionate about helping identify, prioritize and quickly eliminate obstacles in the way of a healthy revenue cycle. We provide the right people with relevant expertise to maximize your people, processes, technology, and results. Together, we build sustainable operational improvements generating a more efficient operating state with increased revenue.
Iodine, started by the founders of Advisory Board’s Crimson offering, is a technology focused entirely clinical documentation integrity (CDI). Even with well-established CDI programs, hospitals leave significant return uncaptured, often measured by under-payment and poor quality outcomes. CDI teams nationwide are tasked with identifying instances where physician documentation does not fully reflect the condition or severity evident in the complete clinical record. Unfortunately, existing documentation and coding-based solutions routinely miss opportunity hidden in the complex mass of discrete clinical evidence. Iodine avoids the pitfalls of coding and NLP (natural language processing)-based solutions by directly comparing the full clinical record to physician documentation, in real-time. Backed by Machine Learning Artificial Intelligence applied to millions of patient records, Iodine brings unprecedented statistical power to identify possible conditions not evident existing documentation, allowing Iodine to capture and prioritize documentation opportunity which other solutions routinely miss. As a result, CDI teams work on the right patient-records at the right time - when they have meaningful documentation deficits. Iodine remains the fastest growing CDI technology, which now includes 2 of the top 3 largest health systems. Our customers enjoy improvements to CDI workflow efficiency, documentation corrections, CMI accuracy, and millions in mid-cycle financial return; our ROI is demonstrated across our entire client base, not just a few anecdotal success stories.
KIWI-TEK – Our remote coding is designed to help you with any type of patient service regardless of your workflow, coding applications or record format. We concentrate on three core areas of competence; ACCURACY, SPEED and ROI. Our team of expert, certified coders can code on your HIS platform, using your document management system and encoder. You gain the advantage of utilizing our staff without managing them on site. We offer both PRN and a Total Outsource of medical coding. Please visit our website www.kiwi-tek.com
Link Revenue Resources (LRR) partners with healthcare organizations to provide solutions that enhance and expand upon your current revenue cycle by recovering incremental cash to improve your bottom line.
- Bad Debt Recoveries Program: LRR utilizes analytically-based treatment optimization models and a complex agency network to identify and deliver incremental value embedded in fully- reserved healthcare receivables. The Program begins after the client has completed their entire revenue cycle process. Over a three-year period, the average recovery rate is 4% of face value.
- Zero Balance Account Service: LRR, utilizing the structure of the Bad Debt Recoveries Program, specializes in both primary and secondary zero balance recovery treatments.
Managed Care Revenue Recovery Group (MCRC Group), is a highly skilled, accomplished team of health care professionals with over 60 years combined work experience with academic and community hospitals, physician practices, as well as large national and small regional health plans. MCRC Group excels in the areas of underpayment identification and revenue recovery (both zero balance claims and aged receivable). MCRC Group goes beyond where software is capable of going and performs a forensic analysis of claims data for each hospital service, for each payer, on a claim by claim basis, finding additional dollars due to your hospital. The founders of MCRC Group have many years of experience on both the hospital and health plan side in crafting managed care contract terms and rates, understanding the limitations of payer systems, knowledge of conflicts and various interpretations of contract language, and working first hand with payers to correct system issues, uniquely qualifies MCRC Group to identify opportunities for greater revenue and collect more money due to providers. MCRC Group investigates claims for all services, and both inpatient and outpatient, regardless of the level of expected reimbursement or the amounts still due the provider. MCRC Group has no limitation or threshold to pass in order to pursue underpayments - no variance is too small.
Professional Finance Company (PFC) has been working together with our partners and their patients to resolve account receivables in a manner consistent with our core values of Integrity, Accountability, and Professionalism. Many of today’s providers have frustrations or concerns with the level of work being performed on their accounts, lack of customer service provided to their patients, or potential exposure to risk in today’s era of compliance. First Party Receivables Solutions (FPRS), a division of PFC, provides comprehensive Insurance Follow-up and Self-Pay Early Out programs that offers a patient centric approach to your community. Through PFC, we handle both primary and secondary bad debt collections with a focus on technology that adheres to compliance standards while creating additional opportunities to work with the patient. PFC Funding II offers a purchase solution for older, distressed receivables. Portfolios are handled through PFC’s normal collection processes and we contractually agree to never resell.
Pinnacle Healthcare Consulting (PHC) provides a range of strategic, financial and operational services to help hospitals, health systems, physician groups and other health care organizations improve their clinical and business performance. Pinnacle Healthcare Consulting is a trusted advisor to hundreds of hospitals and health organizations around the country. The firm specializes in business and compensation valuation services, service line strategy and physician alignment, cost reduction strategy/supply chain and operations improvement, physician practice management and compensation planning, medical billing/coding audit and compliance support. This complement of expertise is backed by an experienced team that distinguishes Pinnacle in the industry and delivers dynamic solutions for its clients’ most complex challenges.
We make the lives of providers and patients easier by incorporating innovative tools, behavioral science, and analytics to improve financial engagement and resolve financial obligations. We also operate on the premise that patients want to pay their bills, but sometimes need flexible and convenient options, and appropriate guidance and communication to help them manage their financial challenges. With more than 80 years of experience, we are industry leaders and strategic experts in accounts receivable management, offering collection services that yield above-expected results while treating your patient with complete respect.
As part of the Hawes Group of companies, and its affiliation with KG Hawes, a consumer engagement technology partner, as well as Hero Business Services, its self-pay early-out partner, Professional Credit is able to offer a wide range of patient financial services and technology.
Quest Diagnostics is the world's leading provider of diagnostic information services that patients and doctors need to make better healthcare decisions. We offer the broadest access to diagnostic testing services through our network of laboratories and patient service centers and provide interpretive consultation through our extensive medical and scientific staff. Quest Diagnostics is a pioneer in developing innovative diagnostic tests and advanced healthcare information technology solutions that help improve patient care.
At a Glance - Quest Diagnostics is the world's leading provider of diagnostic information services
- Generated 2017 revenues of approximately USD 7.7 billion
- Publicly trades common stock on the New York Stock Exchange (NYSE: DGX)
Recondo Technology was founded in 2007 with the goal of developing solutions and services to bring automation, realized by every other industry, to the healthcare revenue cycle. In the US currently, health care spending is approximately $3.4 trillion annually, and on track to reach 25% of GDP by 2025. The cost of getting paid for providing healthcare services is more than 15 percent, or about $510 billion, annually. Compared to other industry segments, health care revenue cycle processing remains extremely inefficient; for example, the retail segment settles transactions for less than two percent of revenue, and financial services settles transactions for less than one percent. If health care could settle revenue cycle transactions for even 10 percent of revenue, industry savings would exceed $170 billion. Recondo was created to assist healthcare providers to get paid more, faster, and at a lower cost.
Recondo® currently offers patient access services for patient estimation (SurePayHealth®), comprehensive eligibility and benefits (EligibilityPlus™), authorization management (Auth-DP™), financial assistance determination (FinancialAssistance), patient-driven price transparency (MySurePayHealth) and automatic claims status retrieval and workflow routing (ClaimStatusPlus™). Fundamental to all Recondo services is the automation of patient encounters. Recondo connects to more than 500 payer websites via ReconBot® technology, and most patient transactions and encounters can be processed without any user intervention due to the capture of data absent in the EDI 270/271. With this automation, resources are freed up to focus on collecting from patients and managing exceptions. In addition, Recondo also performs accuracy analysis for patient estimates. This includes the analysis of estimates, electronic claims (837) and remittance (835) to determine controllable vs. non-controllable measures to adjust in order to increase calculation accuracy.
Recondo has extensive experience with systems integration. Currently, the Recondo Integration team has provided integration services and support for all leading Hospital Information (HIS) and Scheduling Systems, including EPIC, Cerner, Meditech, Siemens, Eclipsys, McKesson, GE, CPSI, and NextGen. The team also has delivered integration services and built interfaces to a wide-ranging number of hospital applications and associated databases. These applications include Scheduling, Pre-Registration, Registration, Orders, ChargeMaster, Medical Records, Contract Management, Claims, and others.
RevSpring is a healthcare technology solutions provider focused on patient engagement interactions. Our emergeTM Intelligent Workflow SolutionsTM (IWS) combines our patient engagement and payment technology solutions with a proprietary data warehouse and business rules engine. This end-to-end integrated patient engagement solution segments patient populations to deliver targeted personalized messaging using big data, advanced analytics, sophisticated business rules and workflow automation throughout the four key touchpoints of patient revenue cycle: pre-service, point-of-service, post-discharge and follow-up. Utilizing the IWS tools allows our clients to influence patient response in changing the patient’s behavior, allowing for adjustments to strategy and continual optimization of your engagement workflows.
Located in Deerfield Beach, FL, Sentry Data Systems, a pioneer in automated pharmacy procurement, utilization management and 340B compliance, is leading the healthcare industry in utilizing advanced data analytics to reduce total cost of care, improve quality and provide better outcomes. More than 9,800 hospitals, clinics, integrated delivery networks (IDNs) and pharmacies across the country rely on Sentry’s unique proprietary data set for their analytics, procurement, drug utilization and compliance solutions. Since 2003, Sentry’s solutions have processed over 7.4 billion dispensations on more than 1.4 billion claims and currently provide decision support for more than 95 million patients. To date, Sentry has helped hospitals, health systems and IDNs realize more than $6.8 billion in savings to help them better meet their safety net mission and continue to serve their communities.
Simplee® is transforming the patient financial experience. Founded in 2010, Simplee’s mission is to make healthcare consumer-friendly. The Simplee software platform is healthcare’s leading solution for patient financial care. With Simplee, healthcare systems across the United States are engaging patients with a unique and proven consumer experience. From pre-service to bill to payment, Simplee helps providers build rapid trust and pave a path to payment (and loyalty). Simplee customers enjoy higher patient satisfaction, lower costs, and better payment success.
State Collection Service was founded in 1949 by Hilding Haag and now employs over 500 individuals. The company, which is now on its third generation of family ownership, has served the healthcare industry nearly 70 years. Of our over 280 hospital clients, State Collection Service has experienced long lasting and mutually beneficial working relationships with medical providers around the country. In total our healthcare placements for early out services (in the client’s name) and bad debt exceed $3.8 billion annually. We are fortunate to work with some of the most prestigious healthcare systems in the nation. Our wealth of experience will provide your organization with time-tested and proven collection methodology, extensive quality assurance standards, and customer service processes that are healthcare-specific and designed to establish a successful partnership with your office. As a result of our focus on serving the healthcare industry, we have developed the people, processes, and technology to create exceptional value and resources for our healthcare clients. These resources include among other things: - Comprehensive implementation process for a seamless, efficient new project set up and decreased time and resources for your staff devoted to the set up process - Quality-rewarded representative compensation (including a zero-tolerance complaint policy) - Client Service Executives knowledgeable of healthcare business offices - Healthcare specific representative training programs including HFMA’s CRCR program - Client-specific training and informational training documents including your financial assistance polices - Extensive compliance mechanisms through a dedicated Compliance Department Moreover, our commitment to training as well as the use of speech and data analytics provide you both improved recoveries and improved patient satisfaction. From our customer service philosophy and extensive implementation process to how we train our representatives and measure their performance, being the BEST in our industry fuels our drive for success. We believe that the methodology and administrative approach we have refined during our 68 years of serving the healthcare industry your facility the best performance, and ultimately the most value to your business office as an account receivables partner.
Structured Analytics recovers underpayments from your zero-balance Medicare/Advantage IP and OP claims. In addition to revenue recovery, Structured Analytics identifies root causes to prevent future errors.
Triage Consulting Group is one of the nation’s leading hospital revenue review firms. Our 500+ consultants specialize in hospital payment review and recovery, revenue cycle improvement, and contract analytics. Since inception in 1994, we have recovered over $4.5 Billion for over 900 hospitals, with over $550 Million collected in 2017 alone. Our fee is 100% contingent upon the revenue we recover.
Triage reviews closed (zero insurance balance) patient accounts to determine whether they were coded and billed correctly and subsequently paid correctly per health plan contracts or government fee schedules. We start every project with 3 Objectives: 1) Find and recover cash; 2) Minimize the risk of future loss; 3) Provide contract analytics and payer performance analysis. When we discover lost revenue, we work with the payers to recover the additional amounts due. We then work with your team to “plug the leak” and prevent the issue going forward.
Our mission is simple. We want to maximize hospital revenue, causing minimal disruption to your staff with zero investment to get started. Our process finds revenue opportunities other firms miss. Our reporting is clean, detailed and frequent. Our teams are well-trained and our results immediate.
Founded in 2009, VisiQuate offers proven solutions that manage the volume, variety, and velocity of Big Data. The company’s enterprise-scale Business Analytics integrate and simplify complex data and present it as insights and actionable workflows. For users at all levels, the app-like visualizations feel more retail than corporate. Hidden root causes, trends, and opportunities become clear, and lead directly to real-world results. VisiQuate clients also benefit from the collective experience of industry domain leaders who help them achieve the best performance outcomes. Headquartered in Santa Rosa, CA, VisiQuate currently serves clients in healthcare, finance, and other industries. For more information, visit www.visiquate.com or contact firstname.lastname@example.org
Xtend Healthcare is one of the fastest growing revenue cycle solution companies in the industry, offering 100 percent on-shore solutions. Our senior management team has more than three decades of dedicated hospital revenue cycle experience with hundreds of hospitals and hospital systems in over 40 states. Xtend Healthcare clients range from large teaching hospitals and urban medical centers to rural critical access hospitals. We have experience working with large non-profit and religious affiliated hospital systems as well as the largest for-profit healthcare systems. Xtend Healthcare offers cutting-edge technology, experienced staff, and 100 percent customer satisfaction.
Xtend has the ability to place full teams of experienced billing and collection personnel on site with expert consultants in all revenue cycle areas including patient access, business office, self-pay management, HIM, and IT systems relating to revenue cycle. The result is immediate cash acceleration and accounts receivable resolution combined with long term revenue cycle improvement through best practices. The fast pace of change in revenue cycle technology systems requires individuals with the skills to identify the current best solutions, and we have the individuals that not only are familiar with the best available but know how to select the most reliable alternatives.