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5 Reasons Our Lab RCM Services Stand Out

The medical billing industry is without a doubt one of the most overly-saturated industries there is. One could imagine that it would be a monumental endeavor to own this space, and to a degree, they would be right. But it’s easy for Phoenix Healthcare Services to stand out amidst the chaos because we provide lab-specific RCM services that are nearly non-existent in today’s medical billing world.

So, the big question is; how exactly are we different from other RCM providers?

Well, we’re happy to tell you.

Ways We Stand Out

1. We Specialize in Lab RCM Services

We have a versatile team of billing specialists that are exclusively dedicated to laboratories and their billing needs.

2. We Have Hand-Crafted Laboratory Dashboards

Discover golden nuggets of data, make smarter decisions, empower your team, and ultimately, improve your bottom line with our next-level dashboard technologies.

3. We’re All About Accuracy

We understand that accuracy is one of the most significant laboratory RCM challenges. Our custom dashboards will help your organization avoid unnecessary write-offs and sample net losses while helping to increase coverage discovery, confirm patient activity levels, and boost probability of payments.

4. We Serve a Multitude of Labs

We’re not kidding when we say we specialize in laboratory RCM. We serve CGx, PGx, allergy, molecular, toxicology, and women’s health labs.

5. We Have an In-House Payer Enrollment Team

We don’t outsource anything. We have a dedicated lab payer enrollment team that will help you navigate and manage your individual or group enrollment to avoid costly delays, manage contracts, protect revenue streams, and stop delays in cash flow.

Happy Clients

It’s easy to toot our own horn, so here’s a testimonial from one of our happy clients:

“The team at Phoenix Healthcare Services has been amazing. They view our relationship as a partnership, not simply as a client. Their transparency and guidance throughout the billing process have allowed us to make improvements to our processes that will continue to pay off in the long run.” – Valued client since 2017

Meet Our Laboratory Specialist

“Laboratory RCM data flow is complicated and payer requirements are constantly changing. By successfully managing claims from all 50 states our dedicated laboratory team has developed a streamlined process to maximize efficiency and improve our clients’ overall financial performance.”

Alison Page / Laboratory RCM Specialist
Team member since 2016


Conclusion

In 2008, we set out to change the world of Revenue Cycle Management. With a 100 percent client satisfaction history, 5,000+ payer enrollment track record across all 50 states, and a 98 percent clean claim rate, we’re confident that we can help any laboratory improve their bottom line and outshine the competition. To schedule a demo, just [click here], select a day and time that works for you, and prepare to take your lab’s RCM to the next level!

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Telehealth: A Worthy Addition to Your Practice

Telehealth (sometimes referred to as Telemedicine) is a combination of the ways in which a patient can connect with a physician outside of their office (most often via the internet). The technology has enabled physicians and their practices to communicate with patients through video chat, text messaging, and email automation. It has grown in popularity and state laws across the country are supporting more and more physicians in this technological movement.

Telemedicine, which means: “healing from a distance,” can be traced back as far as the 1800s. Modern forms of telehealth surfaced in the 1960s and 1970s through military and space enterprises. And on December 21, 2017 – telehealth policies were approved by 34 state legislatures, according to the Center for Connected Health Policy.

With an increase in American health insurance coverage, as well as changes in patient-centered care, the need for physicians to be accessible outside of the office is greater than ever.

Methods of Delivery

Telehealth is comprised of three distinct methods of administration. These would include:

Live Video

Live, two-way communication between a patient or caregiver and a provider through a computer or mobile device. This type of service serves as a substitute for an in-person meeting when it’s not available. Live video can be used for consultations, treatment, emergency, and diagnostic services.

Remote Patient Monitoring (RPM)

Remote patient monitoring helps providers track healthcare data for patients once released to home care. RPM has been shown to help individuals stay healthy in their home and community, without having to commute to a providers’ office.

Pre-Recorded Video Transmissions

Pre-recorded videos by patients, that are then sent to a practitioner (often a specialist), who uses the information to evaluate their case and render care outside of live interactions. It’s a viable option for when there are limited board-certified specialists available.

How Can Telehealth Benefit Your Practice?

Below are four reasons why we think Telehealth is a good investment for your practice:

1. Cost-Effective for Patients

Many Americans, unfortunately, have expensive health insurance plans, and in some cases, can benefit from using telehealth technology. For instance, an emergency room visit can cost someone hundreds of dollars, while a telehealth visit can cost as little as $40. When you and your staff are unreachable (due to weekends or after hours calls), patients can choose to communicate with a designated on-call doctor — possibly saving them a trip to the ER.

2. Gives Your Practice a Competitive Edge

Healthcare consumers all share a common need; convenience. What could possibly be more convenient than a visit to your doctor without having to leave the house? An organization that offers telehealth undoubtedly has a huge advantage over their competitors.

3. More Relatable to Younger Generations

The colossal tech entity, Salesforce wrote a report called “The State of the Connected Patient 2015,” detailing the significant shift in how patients communicate with their providers — particularly younger patients. According to the report, 60 percent of Millenials prefers to eliminate in-person health visits, and 71 percent said they’d like to see more providers use an app to book appointments, share health data, and manage preventive care.

4. It’s a Timesaver

There are countless small practices in busy cities and rural areas that are overbooked and stretched thin. Telehealth video consultations can save both the provider and the patient time and money. Between the reduction of primary care physicians and a growing demand for basic healthcare, it only makes sense for organizations to adopt new lines of patient communication to help bridge the gap and maintain a healthy bottom line.

Conclusion

There are a significant number of reasons to consider adding telehealth technologies to your list of services. Truth-be-told, the main obstacles are often intimidation and uncertainty. New technologies have a tendency to do this to people of all walks and professions. But if your practice is to survive the test of time, it will need to be open to ever-evolving technological advances and modern milestones. Soon, all 50 US states will be behind Telehealth [Telemedicine], and the transition is more simple than you might think.

We suggest you do your own research. Weigh all the pros and cons, and if telehealth is something that interests you, then we’d love to help you make sense of it all by speaking with one of our Telehealth Experts.

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5 Useful Tips for Negotiating Rates with Payers [Infographic]

Negotiating with Goliath-sized payers can be an intimidating experience for a Healthcare organization. But being small has it’s advantages too. When a small organization is able to prove that the higher rates are affecting their bottom line, payers are more likely to negotiate a lower rate — especially when the practice is able to present unique value, in a unique way.

Here are 5 simple negotiation strategies we’ve seen work for organizations of all shapes and sizes.

1. Speak With the Right Person

We’ve all spent a ridiculous amount of time on the phone with someone, only to find out that they don’t have the authority to make important decisions. This is why it’s important to ask early on if you can speak with a supervisor or executive who is able to negotiate. Ideally, you need to locate a service representative at the company who handles incentives and contracts.

“Preparation is a big part of the game.”

2. Communicate Your Value

As previously mentioned, building a strong value proposition is important. Is your organization accredited? Do you have a lot of positive patient reviews? Do you provide services in an area where there aren’t many other providers, do you care for a special demographic of patients not treated by other local physicians or provide a unique lab test? Preparation is a big part of the game, and if you show up with an impressive list of credentials that showcases your organization’s strengths, you’ll be more likely to reach a rate that works for you.

3. Build Trust with Good Data

Once you’ve established that you’re talking to the right person and you’ve shared value, it’s time to negotiate. But before you begin, it’s important to have your data on hand. Your organization should provide simple data that shows the level of quality care you provide for happy patients while containing costs. This will establish trust and build credibility on behalf of the provider.

When a practice is able to paint a mental picture of stability and financial integrity through the use of good data, it gives even the smallest of practices a negotiating advantage.

“Don’t be afraid to counter offer. You might be surprised.”

4. Negotiate with Confidence

When it comes to negotiating, a lot of insurance companies use a “take it or leave it” approach. But if the organization has something unique to offer the payer, they could find themselves in a great position to negotiate. There’s also something else to consider. The payer likely already sees value in the organization, otherwise, they would not have made it this far in the payer enrollment process.

If insurance companies want to hold their spot in the super-competitive healthcare market, they’ll need to make deals with a small organization more often than not. When organizations communicate their value early in the meeting, they’ll be able to leverage their negotiation power and reach an agreement that makes everyone happy.

If all else fails, out of network contracts or single case agreements are always an option. Make sure you have the expertise to financially model in-network, out of network or single case rates to make sure you negotiate the best possible rate.

5. Counter Offer

Sometimes you’re just not going to get the rate you want. Not to worry, negotiations aren’t over yet. For example, you can ask for better terms on the window for resubmitting claims, or for ways to streamline the prior authorization process. The point here is not to give up. Don’t just roll over for the giant. Don’t be afraid to counter offer. You might be surprised.

Conclusion

Negotiating can be exciting for some, while dreadful for others. Ideally, hiring an expert (middleman) that can do the negotiating on your organization’s behalf is the better choice. But if you’re going to go at it alone, make sure you speak to the right person, be prepared with data, negotiate with confidence, and above all, communicate your unique value. We all have strengths — something that makes us “special.” Proudly expose it and get the rates you desire.

5 Tips to Maximize Payer Enrollment [Infographic]

Payer enrollment can be complicated, but it doesn’t have to be. Experienced medical staffing professionals understand that credentialed providers cannot generate revenue until they are enrolled with payers. Moreover, healthcare organizations are reliant on a streamlined payer enrollment processes because of its impact on the team’s bottom line.

We get a lot of questions about payer enrollment, so we feel like it’s our duty to share a few of our top tips to help with your payer enrollment and credentialing endeavors.

So, what does the ideal Payer Enrollment Solution look like? We’re glad you asked. Here are a few advantages you’ll have when working with experienced PE specialists:

  • Get enrolled faster with proven proficiencies
  • Receive important updates and notifications with custom dashboards
  • Make better-informed decisions and unlock hidden income potential
  • Save time with a streamlined credentialing and expirables workflow
  • Avoid costly mistakes and maximize cash-flow velocity
  • Keep sensitive data safe and secure in our HIPAA compliant software

Are you convinced yet? Let’s get to the good stuff. Here are our 5 tips to help your organization maximize its payer enrollment process:

1. Keep it Simple

As we previously mentioned; payer enrollment can get downright complicated. That’s why it’s crucial to have the right experts (and technologies) in place to help you manage all your payer and provider data. A (simple) streamlined process for payor enrollment is vital when it comes to increasing your revenue.

2. Choose the Right Payers

Not all payers are designed equal. Choosing the right payers that align with your organization’s needs is critical, so it’s important to find an expert that is willing to establish a list of insurances that will benefit your bottom line.

3. Maintain Clear Communication

When different enrollment departments are on the same page, good things happen. By implementing a cross-cultural management system, you’ll organization will build an ecosystem that results in maximum efficiency, productivity, and financial growth.

4. Be Transparent

If your practice doesn’t embrace change, it will always struggle. This is where custom enrollment dashboards really shine. Combining enrollment and revenue data in a customized dashboard allows you to make more informed decisions. Having access to key data fields and KPI’s is golden for any healthcare business.

5. Be Proactive

Working with a dedicated enrollment specialist that is proactive in nature is important when it comes to speeding up the insurance enrollment process and, when necessary, working through appeals.

Conclusion

When it comes to building a rock solid payer enrollment process, strategy, technology, communication, and transparency all matter. You can try to go at it on your own, risking errors, security breaches, revenue loss, and ultimately, burnout. Or, you can invest in the kind of expert help that will give you a significant advantage over the competition. The question we need to consider is: “Is my practice worth it?”

5 Ways to Improve Revenue Cycle Management [Infographic]

Are your revenue cycle management systems underperforming and losing profits? Don’t worry; you’re not alone. Traditional medical billing services or in-house infrastructures are no longer working, and this is causing many healthcare professionals to be challenged in new ways by the complexities of an ever-evolving, multi-trillion dollar industry.

Inexperienced staff, insufficient coding practices, billing errors, technological challenges, inaccurate data, workflow inconsistencies, declining reimbursements, and law breaches all play a role in poor RCM results. It’s no wonder why revenue cycle leaders are always looking for new ways to improve the financial health of their practice. But the reality is; improving systems and cutting costs within a healthcare organization is easier said than done.

The truth is, revenue cycle management is one of the most challenging tasks for a healthcare professional to handle.

Healthcare professionals often interact with several stakeholders before receiving complete payment for services. The myriad of payer rules for claims reimbursement, as well as the popularity of high-deductible health plans, has revenue cycle experts reaching out to several points-of-contact to obtain a portion of the payment.

Let’s not forget coding accurately and auditing personnel — an often overlooked and under-considered facet of any healthcare practice. Even the most efficient RCM operations are vulnerable and often susceptible to insurance take-backs and fines due to poor coding.

The truth is, revenue cycle management is one of the most challenging tasks for a healthcare professional to handle. However, practice leaders can implement strategies for lasting RCM success, but before we delve in, let’s look at what happens when your revenue cycle management systems underperform.

Consequences of Poor RCM

Ineffective RCM systems are not only affecting your bottom line, but dated billing methods are shifting the entire healthcare ecosystem. Below, are just a few areas in which less-than-efficient RCM systems are hurting your organization.

  • Increase in claim denials
  • Decrease in collections
  • Limited patient payment options
  • Workflow inconsistencies
  • Increased accounts receivables
  • Unnecessary write-offs
  • Limited access to data and custom dashboards

Healthcare professionals that do not successfully leverage premium RCM tools could be putting themselves at risk for unfavorable outcomes, including being forced to close their doors.

The Solution

If modern healthcare organizations are going to survive and thrive in the 21st century, they’ll need to foster a forward-thinking attitude and consider all possibilities for RCM improvement. Below, are 5 ways to improve your revenue cycle systems:

1. Make Your Data Work for You

Data will tell you the financial health of your organization. Implementing a data-driven healthcare revenue cycle model will help your staff become more efficient in their efforts to perform tasks needed for fast and accurate reimbursements.

Your data has to be viewed three-dimensionally. Having access to quantifiable and measurable statistics allows you to assess the health of benchmarks, trend lines, and performance indicators. Your organization should have next-generation dashboard technology solutions in place—with RCM experts that know how to combine multiple data silos.

Nearly 75 percent of providers have reported a significant increase in patient financial responsibility in the last few years.

Sophisticated data-tracking technologies are ineffective without top-notch experts that know how to manage them properly.

2. Provide Payment Options for Clients

As the healthcare industry continues to evolve, providers are relying more and more on patients to pay out-of-pocket for services. The surge of high-deductible health plans has saturated the insurance market to a degree in which has not been seen. Nearly 75 percent of providers have reported a significant increase in patient financial responsibility in the last few years. [1]

Late and underpaid patient financial responsibility slows down healthcare revenue cycles — running the risk of never receiving full reimbursement for services. RCM managers can optimize patient collections by executing point-of-service or pre-service payment alternatives.

An option would be to offer patients financial estimates before, or at the point-of-service phase. A 2016 Pioneer Institute study revealed that over 50 percent of hospitals lack the capability to provide price information to patients. [2] And a Transunion survey showed that 46 percent of younger patients claim that they would be able to pay more patient financial responsibility if they received a cost estimate. [3]

The good news is that your organization can prepare for cost estimates by implementing the right software tools.

3. Seamlessly Connect Departments

Healthcare and its data have become more complicated than ever. Siloed data, cumbersome processes, changes in government mandates, poor business decisions due to compliance and payers issues, and a multitude of other challenges can get in the way of your organization’s RCM successes.

The real advantage comes with having the right tools and strategies in place to get from information to insight to action! The only way to fully-optimize your revenue cycle process is to merge data, collaborate across departments, and to empower your workforce to ask questions and take action.

86 percent of medical practice leaders reported an increase in prior-authorization requirements in 2017.

Having numerous RCM departments such as coding, payer enrollment, accounts receivable, denial management, and dashboards all under one roof, will ultimately inspire your team and improve your bottom line!

4. Automate Prior Authorizations and Eligibility

A recent MGMA study showed that on average, 86 percent of medical practice leaders reported an increase in prior-authorization requirements in 2017. [4] The surge of requirements could mean trouble for revenue cycles for practices and hospitals.

Manual prior authorizations cost providers on average four times more than electronic prior authorizations, so switching to an automated system can save practices a significant amount of money over time.

RCM managers and providers can ensure a smooth healthcare journey by switching to an automated process. Staff can focus their time on more important tasks, such as patient collections, and organizations can optimize their overall revenue cycle performance.

5. Hire Qualified and Experienced Coding and Auditing Experts

Outsourcing coding and auditing tasks to multiple firms have become popular among practice leaders. But it’s not always the best option. As with any project or multi-faceted operation, the more hands on deck means a higher risk for errors. So, finding an organization that can handle all your revenue cycle management (and) coding and auditing needs is hugely beneficial.

Furthermore, it’s crucial to hire highly experienced coding experts. The good ones will maximize revenues and reduce risks of breaching regulatory laws. Your RCM could be very effective and efficient, but incorrect coding could result in insurance take-backs and fines that would adversely affect your bottom line.

Certified Professional Coders (CPC) and other accredited professionals who are experts in specific parts of the revenue cycle chain are not just optional, but a necessity towards an effective compliance program.

Conclusion

Next-generation data-tracking technologies, increased collections, more patient payment options, better workflow, fewer write-offs, decreased accounts receivables, and balanced front and back-end functions are just a few of the benefits you’ll gain by working with skilled, experienced revenue cycle management experts.

Is your practice worth it? We think so.

What Now?

Sometimes it’s difficult to know where (or when) to start. That’s OK. We’re here to help. Speak to one of our experts, or simply call us at 1-800-729-0976 to learn more about advancing your RCM system to a whole new level.

Increase your bottom line — every time.



REFERENCES:

[1]: https://www.instamed.com/blog/trends-impacting-the-healthcare-payments-market/
[2]: https://revcycleintelligence.com/news/healthcare-consumers-lack-transparency-price-info-awareness
[3]: https://mybillingtree.com/company/blog/getting-millennials-to-pay-their-balance-medical-bills-may-require-a-revolution-transunion-study-suggests/
[4]: https://revcycleintelligence.com/news/86-of-providers-saw-prior-authorization-requirements-increase