Patient Advocacy and Self-Pay Receivable Management Services

Our Patient Advocacy and Self-Pay Receivable Management Program is dedicated to uncovering any and all possible enrollment opportunities for governmental insurance programs, such as Medicaid or Charity Care Programs, to ensure patients are covered
for current and future services.

Our best practices mindset allows for our operations to use all channels to qualify and enroll self-pay patients and continue the necessary revenue stream that our partners rely on throughout the year.

Our Patient Advocacy and Self-Pay Receivable Management Service includes:

  • Review of patient data for accuracy and completeness
  • Use of proprietary technology and processes to match all true Self-Pay accounts for possible insurance coverage
  • Screen all patient accounts for 3rd Party insurance coverage and government assistance program
  • Identify, qualify & enroll patients under the Federal/State Medicaid Expansion Program
  • On-site financial counseling
  • Provide field service representatives to assist patients in qualifying for Medicaid and Charity Care with portable imaging technology
  • Routinely follow-up with Medicaid offices on submitted applications through disposition
  • Reconcile the number of Charity Care priced claims against the number of approved Charity Care applications to ensure all applications are submitted to the fiscal intermediary timely
  • Institute a Dual Eligibility Outreach Program to assist elderly patients in obtaining secondary coverage through Medicaid
  • Update all insurance on Client’s system for claim submission
  • Follow-up on submitted claims with payers for timely disposition
  • Manage payment arrangements with patient friendly reminders
  • Utilize predictive dialing and call recording technology to maximize patient contact and ensure quality
  • Apply Risk Factoring across each performance grade (Patient Scoring) to enhance outcomes
  • Monitor accounts using aging reports to ensure accounts are actively being worked
  • Provide monthly liquidation reports to ensure performance meets or exceeds industry standards. Provide monthly payment reports to clearly identify areas of reimbursement
  • Provide feedback through monthly meetings to assist Customers with revenue cycle improvement initiatives
  • Assist Customers with Key Performance Metrics to provide revenue cycle outcomes related to Self-Pay accounts

Expected Outcomes:

  • Convert Self-Pay revenue into insurance revenue
  • Increase insurance repeat revenue
  • Improve accuracy of patient data
  • Improved Cash from uninsured/underinsured patients
  • Decrease Bad-Debt placements and costs to collect
  • Improve visibility on Self-Pay Accounts Receivable
  • Lower days in Self-Pay Accounts Receivable
  • Improved reporting and key performance indicators
  • Improve patient communication and satisfaction

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We provide Hospitals & Health Systems with comprehensive revenue cycle management services

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