Complete Revenue Cycle Management Services
If you've been trying to manage your own revenue cycle, you probably feel powerless and at the mercy of coders that do not specialize in what you do. You are having to deal with payer's convoluted reimbursement rules, being squeezed over rates during contract negotiation, or fighting a payer's delay tactics - Not to mention cutting through government red tape.
With ConsensioHealth, you can concentrate on practicing medicine!
ConsensioHealth provides a full suite of Revenue Cycle Management (RCM) solutions. While your parent organization handles most all of pre-service functions, ConsensioHealth handles the comprehensive post-service Revenue Cycle functions, detailed on our Revenue Cycle Diagram below.
We have over 30 years of experience in:
- Insurance contract management & analytics for independent physician groups
- Credentialing management
- Certified emergency medicine coding
- Comprehensive medical billing management
- Independent audits
Medical Billers and Coders Capture All Potential Revenue
ConsensioHealth uses certified medical coding auditors to double check everything done in the patient’s room is coded correctly so you receive credit to bill everything you do.
We also reconcile – we meticulously go through each patient’s visit and every chart to make sure the number of visits recorded on the ED log or at the registration desk match the number of claims billed that day. This allows us to catch issues every day.
Monitoring Coding Acuity Level Trend Daily
How does your acuity trend match with your peers in your state and nationally?
Our auditors ensure that the proper ED acuity levels are billed based on your thorough documentation. If something’s missed in the system, we alert you before the claim is filed. We’ve also created our own proprietary RCM software, SensER that helps us slice and dice that data.
Feedback on Physician Documentation
If documentation is lacking, feedback and properly training the providers is critical. ConsensioHealth finds instances where the provider is not getting credit for what they did in the patient’s room due to their own lack of documentation. We review with the providers exactly what is required for each level of service and make sure they document everything they do.
Making Sure Every Visit Gets Billed
Reconciliation is important, especially for new clients. For example, let’s say we see 500 ED visits on a log and only 480 claims were billed that day. What happened with the 20 visits that weren’t billed? ConsensioHealth hunts those down. Although some missing claims are legitimately not billed due to a patient leaving before they were seen or a similar situation, we’ll find the instances where there was a missing signature, missing charges and other opportunities lost right away. We fix those in the front end to ensure your claims are promptly filed.
Ensuring No Money is Left on the Table
ConsensioHealth knows the revenue cycle and all its critical points. Let us handle the business of coding and claims so you can focus on seeing more patients and practicing medicine. ConsensioHealth chases the dollars for you.