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3- STEP PROCESS FOR MAXIMIZING REVENUE & BUILDING COST EFFICIENCY

Unique hybrid workflow with an existing EHR

CLINICSPECTRUM’s consulting and back-office services to reduce operational cost upto 30%

3 Steps are:

Step 1.Monthly Audit Management for Accounts Receivable

Step 2:Evidence based Recalls and performing Diagnostic Tests/Procedures and Annual Wellness Visits for better patient care and risk management.

Step 3:Streamlining office workflow with the use of technology and daily reporting for all administrative tasks.Implementing accountability at all levels in the practice, improving productivity and cost optimization.

Let's see each step in detail.

STEP 1:
Monthly Audit Management for Accounts Receivable(First Step for Revenue Growth up to 10%)

Streamlining office workflow with the use of EHR and back-office services for following up OUTSTANDING claims every 6-7 weeks. This process alone with increase collections by 10% or more

EHR’s Claim Follow up Management provides a comprehensive list of claims that are outstanding by PRIMARY payer, Secondary Payer, and Patients.

CS’s AR Follow up Team can conduct Monthly Audits for all claims that need a phone call. Our team would make that call and add remarks into EHR for future tracking.

CS would also compile a list of claims that need CORRECTION and forward it to Billing Team in practice.

Cost per call is $2.25 compared to $4.00 in office.

Builds up knowledge base for Denials by payers for an active Denials/Appeals Management.

Enables team members to finds the status of outstanding claims and document it with time/date and reference#.

Question Insurance companies’ rep if previous (last) call status and current (this) call status is identical for that particular claim, as this indicates that no further action was taken on the claim.

Ensures competency as the AR teams are familiar with all medical policy and guidelines for claims.

Team Members question payers if protocols regarding following clean claim act (OR) Adjudicating claim, as per company’s claim adjudication policy, are not followed.

STEP 2:
Evidence-based Recalls
Performing Clinically Necessary Tests/Procedures
Annual Wellness Program

PRE-VISIT PREPARATIONS Working on Clinical Decision before Patient’s Arrival.To be completed by clinical team, 24 hours in advance of patient's visit.

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• Look at Problem List .
• Last Test and Procedures .
• Last Lab Results .
• Last Annual Well Visit .
• Identify Plan of Care .
• Make a List of Clinically Necessary Procedures Based on Current Problem list and Previous Assessment.

CS’s back-office physicians panel can help you with mentioned process.

STEP 3:
Streamline Office Workflow through Technology and Back-office Team members.

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Receptionist’s Checklist
includes:

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• Verify the date & time of last office visit.
• Makes Sure that Demographic Information is up to date.
• Address any system Alerts for Financial/Insurance Issues.
• Collects patient balances due to co-Insurance/Co-pay/Deductible

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• Review any Alerts for clinical reasons, such as preventive test/recall based on conditions and previous treatments/Procedures.
• Distribute Pre-Visit and/or Medical Necessity Questionnaire for Diagnostic Tests and Procedures

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• If Patient was ordered an outside Test/Procedure/Referral, were those completed and are reports available?
• Appointment Scheduling upon patient’s check-out

FRONT DESK TASKS:

Eligibility

• EHR’s Direct B2B Connection can check upto 70% of Eligibility
• CS Team can provide Eligibility Services for remaining 30% patients that need a Representative Call.

Appointment Confirmation

• EHR’s Automated Engine can schedule calls / text messages / email notification for Appointment Confirmation.
• CS Team can provide appointment confirmation for those high-value procedures through Representative Calls.

MEDICAL RECORDS:

Scanning & Indexing

• EHR’s Document Management Module allows you to route IN BOUND FAXES or Scanned Images to correct patients’ chart however that process of INDEXING could be time consuming for practice. Indexing process can be simplified with CS back-office team and reduce cost of indexing by 40% or more.

Average cost of Indexing per page / file while done with office secretaries is 50 cents whereas same level of accurate services done with CS’s back-office team would cost practice around
10 to 25 cents per image / file.

Make a comprehensive list of all OPERATIONS by department that can be potentially streamlined using back-office team at $6.5/Hour.

We can help you increase your revenue up to 15% & reduce cost up to 30% through this
3-step process
.

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