Revenue Cycle Management

PH3 offers revenue cycle management services that significantly increase average collectible revenues and decreases days’ sales outstanding. We implement our process and services seamlessly into any organization.

PH3 helps you achieve financial health and reduce staff work, enabling you to efficiently assess, plan and improve your organization’s performance. With an efficient workflow and complete visibility into your billing operations, you’re well-positioned to optimize your overall revenue cycle.

Revenue Cycle Management responds rapidly as payer requirements change, resulting in cleaner claims. Our billing modules are continually updated as we receive adjusted or revised requirements from our vast network of providers.

Numerous organizations within healthcare and specific to radiology have reported financial management standards that are below what has been achieved at PH3 Revenue Cycle Management. These include:

• A healthcare group corporation’s DSO at 46.7 days
• A national home health organization’s DSO at 42 days
• A national radiology services provider’s reported DSO ranging from low 50’s to 60 days plus
• A billing services provider’s indicated DSO turn-around time of 45-50 days.

Below is what has been achieved at PH3 Revenue Cycle Management:

Key Result Indicators	PH3 Revenue Cycle Management	Industry Average
Days Sales Outstanding	30.54	42
Average Days for Claims Submission < 7 Days	95%	40%
Average Claims Rejected	1.9%	6.5%

The result? Increased bottom line contribution.

What are our key components?

Effective and customer-service friendly call center processes

• Monitor and manage scheduling of a procedure
• Expertise in procedure protocols

Orders can be received via email or phone to the imaging center, and is often the first point of contact for the facility.  Customer service is critical. High no-show and cancellation rates indicate a lack of communication with the patient/customer.

Pre-registration and authorization

• Knowledge of medical necessity criteria, all payer contract requirements and imaging protocols.
• Experienced staffing will significantly reduce the amount of denials.
• Sensitive and professional communications are conducted with the patient regarding co-pays, deductibles and other payment obligations BEFORE their visit.

Coding and quality assurance

• Automated technology and certified coders reduce denials and days sales outstanding.
• Collections are increased through knowledge of appropriate CPT codes and communications with referring physician offices.
• Data-scrubbing software alerts coders when a problem regarding a claim is identified.
• Best practices, as established by the Radiology Billing Management Association and the American Hospital Radiology Association are incorporated.
• Quality assurance provides checks and balances for orders to that authorization, performance and billing meet compliance standards.

Denials management

• Automated process tools and seasoned payment posters experienced with payers’ Explanation of Benefits work together to pursue every claim and appeal opportunity.
• Experienced professionals identify denial reasons for the purpose of uncovering payer, code or specialty denials, working to rectify and correct problems to reverse denials into accepted claims.

Accounts receivable management

• Bills are coded and dropped daily to reduce DSO.
• Payment intervals are monitored to assure timeliness and established benchmarks.
• Days in A/R are benchmarked – PH3 Revenue Cycle Management is in the 96% percentile at 30.5 days outstanding (benchmark is 45) as well as 98% reimbursement of expected payment.
• Vital and critical component provided to clients is the analytical process to underpaid claims – we compare payments to contracted amounts and flag exceptions, following through on these circumstances for positive financial resolution.

Medical billing claim data quality practices

• PH3 Revenue Cycle Management captures, enters and edits billing claim information utilized in submitting a payer claim, including coverage details and charge information such as CPT and ICD-9/10 codes as determined by the physician or coder.
• Responsibility is taken for staying on top of coding rule and compliance guidelines changes.

High percentage of first-time claim acceptance

• Front-end editing verifies and checks information accuracy and consistency.
• Pre-authorization process unique and distinct from other providers, providing exceptional value within a financial management services bundle.

Electronic claim filing

• In-house medical software utilized for electronic filing.
• Client software can be used, where appropriate.

Patient balances

• Patient collections processes and methods provide the highest level of reimbursement.
• Combined with sensitive, professional communications, PH3 Revenue Cycle Management achieves the same, if not superior, level of patient satisfaction to our clients.

Reporting

• Package includes radiology reports, results and statistics pertinent to practice financial health and productivity.
• Invoices submitted reflect critical elements and provide comparisons to benchmarks and contract projections.

PH3 Revenue Cycle Management helps your organization achieve financial health and reduce staff work, enabling you to efficiently assess, plan and improve your organization’s performance. With an efficient workflow and complete visibility into your billing operations, you’re well-positioned to optimize your overall revenue cycle.

PH3 Revenue Cycle Management offers no-charge consultation to review your Revenue Cycle Management processes and results and will produce proforma projections based on our findings. We also provide a menu of services based on the particular needs of your facility. Please contact us at 913-301-3067.

Or, click here to contact PH3 Revenue Cycle Management via email. We will respond to your inquiry as quickly as possible.