FIND YOUR PATH TO HEALTHY REVENUE

Gene Howell, CEO & Co-Founder

InsightRCM

&

Developed by

If you’re seeing a longer A/R story

than you’d like, repeated claim

denials, have a growing pile of

appeals, or find yourself down-

coding some services because

you’re unclear about the

necessary documentation, then

you will benefit from expert

Revenue Cycle Management

or RCM.

A great revenue cycle starts with

confident documentation from

an EHR that guides visits to the

most appropriate E&M level.

Chart analysis by Urgent Care or

Occupational Medicine experts

ensures accurate industry

coding. Taking processing out of

your office streamlines your oper-

ations and puts the whole system

into the hands of revenue experts

that guarantee your compliance.

REVENUE CYCLE MANAGEMENT

A full service solution that incorporates best practices for workflow, coding, chart

analysis, billing, claims processing, payment, appeals, and collections. It’s a comprehensive solution that begins with driving providers through visits that attain

the strongest, appropriate levels.

End-to-end

systematic

approach

Optimize earned revenue,

documentation

efficiency, & compliance

Complete, EHR

driven clinical

documentation

CERTIFIED PROFESSIONAL CODER (CPC)

Trained to

analyze UC/OM

medical charts

Gold standard for

medical coders Experts in ICD-9,

ICD-10, CPT,

& HCPCS codes

Their continuously updated knowledge of your highly specialized industry

minimizes the impact a shift in regulation or payer behavior has on you.

Able to update &

correct codes in a

patient chart

3

4

5

1

2

Specialty CPCs (certified professional coders)—drive best revenue

opportunities with proper documentation.

FIVE BEST PRACTICES

Ensure EHR workflow leads providers through the right clinical

documentation, like Agility’s PACErs—capture accurate and

complete supporting documentation automatically.

Use electronic billing to reduce days in A/R—increase cash flow.

Automate appeals management—ensure there’s no money left on

the table.

Continuously monitor to ensure that documentation meets medical

justification and necessity (including regulatory compliance)

USE A SPECIALIST

#1

Urgent Care or Workers Compensation services

aren’t the same as family practice. Why would

you use the same coder?

Not all CPCs are the same. For your specialized medical facility you

need specialized revenue cycle knowledge. It’s imperative to your

financial success that you’re billing the most appropriate types of

work for each visit.

What’s gained from an expert CPC? Command of the intricacies of UC/OM coding, billing, and claims processing

An expert trained to read and analyze UC/OM medical charts

and strategically advise on billing codes supported by

treatment documentation

Constant monitoring of UC/OM industry news means they know

changing regulations and carrier denial patters. Use this knowledge to minimize impact at your facility

Did you know: an industry expert CPC find gaps where you’re

not billing or correct coding behavior that’s not compliant

SUPERCHARGED EHR

#2

“Technology is the new workforce multiplier.” - Pricewaterhouse Coopers, Top 10 Healthcare Issues for 2014

An EHR with guided workflow is the best tool you have to ensure

the complete supporting clinical documentation to drive the

highest appropriate level attainment at each patient visit.

Don’t spend extra time hunting for functions, buttons, or fields.

Eliminate the stress of guessing how to raise E&M levels . Ensure your EHR has embedded guides that lead you right to orders.

Providers reclaim the most time in their day by following an

automated workflow that confidently provides full supporting

documentation

Best-in-class UC/OM software understands the impact of both

visit level and coding-billing, and will guide documentation to

drive both revenue and compliance

Did you know: A powerful EHR will have a dashboard that lets

you check the E&M level of your visit, instantly

E-BILL, ALL THE TIME

#3

Take advantage of electronic billing to shorten

your billing cycle and drive increased monthly

cash flow.

Electronic billing can be a huge leap in efficiency for your

facility—especially if you have appropriate automation processes

established.

Insist on electronic submissions. Don’t rely on a human brain to

remember to do it or process it.

Integrate information about standard charges and revised fee

schedules as soon as you know there’s a change—keep the

system flowing accurately

Use software automation to bill encounters accurately. For OM

client (employer) work, automate periodic statements (weekly,

monthly, quarterly) for your billing cycle

Did you know: full chart notes must be attached to Workers

Compensation billing?

TAKE CHARGE OF APPEALS

#4

Data shows that 65% of claims are never

appealed. That means 10-20% of your money

could be left on the table.

Know when you can’t avoid appeals, strictly based on payer

behavior. Minimize appeals, but automate the submissions process

when they’re needed, minimizing days to revenue.

The best RCM services get it right the first time.

RCM strategies are focused on limiting the need for appeals through appropriate supporting documentation

But, appeals are necessary! The Net Health RCM Solutions secures

payment in 70% of appeals.

Payers regularly alter their patterns of denials that cause common

appeals—a UC/OM expert RCM service is up to date on this

information to keep appeals to a minimum

Did you know: Some states allow only one appeal. Others charge

for a second appeal. It’s critical to get it right the first time!

STAY IN STEP, THINGS CHANGE

#5

It’s a specialized industry. Changes are always

afoot that will directly impact reimbursement,

compliance, and the success of your business.

Consider the team in your back office. Do they have time to step

out of that role to educate themselves on the broader picture of

the industry? Regularly?

There’s a lot to know. Specialized CPCs, working with your RCM

service, bring this timely, actionable information to your facility.

Experts are aware of payer changes in advance and can alter

your billing tactics to accommodate

Invaluable experience teaches you the tricks of the trade

related to UC/OM billing (like proper coding patterns for specific

medications)

Did you know: expert CPCs drive efficiency in your DME orders—

stock the most reimbursable and clinically effective items

RCM IN PRACTICE

*Average Net Health RCM Solution Performance

50% reduction in

claim denials

70% success rate

on appeals

&

REAL LIFE EXAMPLES

Highlights of Client Results

Increase in collections per chart

Workers Comp, Orthopedics,

Physical Therapy, Urgent Care

Increase in total collections

Workers Comp, Physical Therapy,

Urgent Care

Increase in total collections (w/ improved compliance)

Workers Comp, Orthopedics,

Urgent Care, Primary Care

18%

16%

8%

HAVE ANOTHER EHR?

Agility Software, the only EHR with embedded PACErs (Physician Accurate

Charting Enhancers) that are critical for strong RCM, offers rapid

implementation and training.

Consult an

Agility

specialist

Let us evaluate

your current

situation.

Implement

Agility Software

with RCM

Special offer: Get real evidence. Let Net Health RCM experts review 10 charts (free).

HAVE AGILITY?

Only Agility Software offers embedded PACErs (Physician Accurate

Charting Enhancers), the key a strong EHR integrated, clinically-driven RCM

model.

Consult your Agility

Account

Executive

Immediate implementation and

training launches

enhanced workflow

Let us evaluate

your current

situation.

Special offer: Get real evidence. Let Net Health RCM experts review 10 charts (free).

LEARN MORE