Date post: | 15-Jun-2015 |
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Healthcare |
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Revenue Cycle Management and Business Processing Solutions
Build Long-Term Customer LoyaltyAchieve Lifetime Customer Value
A Different Kind of Partner
HGS’s Extended Business Office Solutions Practice (HGS EBOS) supplements and augments our
clients efforts in Patient Access, Health Information Management and Patient Financial Services
by delivering solutions for financial clearance, medical coding and insurance claim resolution
designed to improve net revenue, reduce bad debt and accelerate cash collections. HGS EBOS
has 400+ full time staff members who deliver the continuum of services from our two business
offices located in Princeton, NJ and Hyderabad, India.
Value We Create for Our Clients: HGS EBOS has a proven track record of exceeding client
expectations for financial clearance, coding accuracy, cash recoveries and denial reversals when
compared to our client’s historic performance. We augment our client’s revenue management
efforts in an ongoing supplemental role or during specific events that typically lead to pressures
on cash flow (patient accounting system conversions, process transformation and redesign
efforts, staff turnover or talent recruitment challenges).
Performance Results
• Over $6.4 Billion in client accounts receivable managed and $2.4 Billion in cash recovered
• Over 26 Million hospital, physician and DME claims processed
• 8.1 Million zero paid denials reversed resulting in $950 Million in payments
• Cash recoveries exceeding client baselines by an average of 21%
• Denial reversals and cash recovered on claims >1 year typically cover cost of EBOS services
• 100% of clients surveyed state that they would buy HGS EBOS’s services again
Rising Above Our Competitors
Why HGS EBOS
Bottom-line benefits
• Proven track record of exceeding client’s historic revenue cycle performance.
• Scalable to client requirements.
• State-of-the art tools, trained staff and experienced management to effectively work client assignments and deliver results.
• Ability to define payer and process issues through root cause analysis enables our clients to design and implement process improvement initiatives.
• Mature and robust Quality Assurance and Compliance programs.
Client and HGS’
Common Values
• Proven track record of exceeding client cash recovery expectations• Ability to scale operations• Secure connectivity• Powerful analytics
Depth andbreadth of HGS’US Healthcare
Business
• Reverse Interface System Capabilities• Proprietary web-based tools for claim and denial work flow, automation, issues tracking, document imaging and analytics • Integrated quality assessment tool
Technology
High Quality Staff:• Patient Accounting Managers • HIPAA trained personnel• Consultants• Clinicians, Certified Coders• Dedicated Compliance and Quality Assurance Team
People
• Standardized and Efficient Processes• Established Quality Assurance and Compliance programs• Identification of process/system breakdowns• Identification of payer trends and issues
Process
HGS | EBOS
Patient Access SupportPerform financial clearance activities for all patient types for scheduled and post-ER visits
Verify all required demographic data, insurance eligibility and benefit coverage, obtain authorizations/referrals
Utilize payer websites, HIPAA 270/271 and leveraging payer provider customer service lines to obtain eligibility and benefits coverage
Evaluate team and client quality and metrics
Analyze 835 data for front end denials to identify trends and performance improvement opportunities
Health Information Management SupportRemote coding capability for all patient types using certified and experienced coders
Detailed analytics for coding related denial trends
Robust Quality Assurance and Compliance Program
Ability to scale coders to meet seasonal and business demands
Process Improvement InsightsRoutine analysis of accounts receivable aging, payer behaviors and denial trends
Customized web-based management reporting
Tracking log of identified process issues and their impact on revenue management
Communication of key findings through regular client updates
Full Suite of Outsourced Solutions
Business Office SupportOngoing collection of targeted aged insurance claims (e.g., claims aged > 120 days)
Focused high volume/low balance claim follow-up
System conversion support (e.g., pre go-live cash acceleration and/or wind down of legacy system accounts receivable)
Early out Worker’s Compensation and Auto Liability account management
Proprietary TechnologyProprietary Claims Management System (CMS) for automated work assignment
Electronic eligibility and claim status inquiries using HIPAA 270/271 and 276/277 transaction sets
Ability to leverage 835s for denial analytics and accelerated resolution
Reverse interface capabilities to post follow up notes and demand rebills to client systems
Proprietary web-based tools to prioritize claim follow-up, track issues and minimize human intervention
“As you might expect, we were pleased with the recoveries considering the age of the receivable we placed, but what really excited our team was their level of partnering with the staff and management. This was a significant benefit we derived from the engagement and as a result of their informative monthly reporting, we were able to address areas of opportunity and prevent future accounts from aging.”
VP of Revenue Cycle for a Faith Based Hospital System (2013)
“HGS shares a lot of best practices with us. They are doing a lot of follow-up calls to the carriers. If they find that a private insurance has a glitch in the system, we can pull the information on the accounts that are fewer than 120 days old and get those corrected claims re-sent to the carriers instead of having to wait longer. They also suggest certain habits that we can implement in our system to prevent the bleed. If we have questions or concerns along the way, we get in touch with our account manager and the senior executives. They work with us and change whatever issues we are having.”
VP of Corporate Billing for a national reference lab company (2013)
“We hired our temps, and HGS was able to present an alternative solution. Due to the expense of temporary staff, HGS was able to deliver a cadre of people overseas for us. They had been through the process with us, so we all worked together to get the staff trained on the financial clearance model. We have been executing that plan with them for some time.”
VP of Patient Access for a major New England based teaching hospital (2013)
Client Testimonials
About HGS
France
Philippines
USAPeoria, ILEl Paso, TXWaterloo, IASt. Louis, MOPrinceton, NJGreenfield, INWarrenville, IL
India
Mauritius
Italy
NetherlandsUK
Colombia
Jamaica
CanadaGermany
Company OverviewGlobal provider of BPO and customer contact center solutions
Over 27,000 employees across 12 countries
Over 120 client programs
Over 50 contact and delivery centers
Over $350 million in revenue
Majority ownership by The Hinduja Group
Global Locations
Providing Services Where You Need Them
TelecommunicationsTechnologyRetailRestaurants and Hospitality
PublishingPharmaceuticalsMedia and Entertainment
Logistics and Transportation
InsuranceHealthcareGovernmentConsumer Products
Consumer Packaged Goods
Automotive Consumer Electronics
Banking and Financial Services
HGS Experience and Recognition
Our clients include Fortune 500 companies and many of the most recognizable brands in the world, some of whom have trusted and partnered with us since our call center services began in 1973. Our clients span an extensive variety of verticals, widening and deepening our knowledge and understanding of many industries.
Dun &Bradstreet
One of the Top ITEScompanies in India
InternationalICTAwardsWinner of the MostInnovative BPO inPhilippines | 2008
NASSCOM
Top 15 ITES BPOexporters FY 07/08
HROA
Gold Medalist inCompetency
Development in BPO
Neo IT
Top 2 call centercompanies globally
Data Quest
Top 10 Employers forEmployee Satisfaction /
HR Practices
ForbesAsia
1 of 200 “Bestunder a Billion”
IAOP
Top 100 Outsourcing List
2010/2011
IAOP
Top 20 by IndustryFocus - Healthcare
United States | Canada | India | Philippines | Mauritius | United Kingdom | GermanyNetherlands | Italy | France | Colombia | Jamaica
Copyright ©2014 HGS, Ltd. | All Rights Reserved
HGS Contact Center and BPO OutsourcingReplaces fixed costs with variable expense that can be quickly scaled up or down as required;
Leverages location-specific benefitsoff-shore solutions maximize value,on-shore solutions offer neutral dialect;
Brings forward-thinking, innovative initiatives to your business; allowing you to focus on your core product.
Build Long Term Customer LoyaltyAchieve Lifetime Customer Value
To learn more about HGS EBOS, please contact:
Michael McGheeVice President – Provider Practice Leader
Princeton, NJ.Direct: (609) 759-5201 | Cell: (732) 310-0831
Email: [email protected] For further information, visit www.teamhgs.com