Communication Solutions

Is it true that an organization is only as successful as the amount of revenue they are able to recover from a client? Systemware is hoping so and plans to strengthen its market share on the concept with the launch of Centraspect HC for Revenue Cycle Management.

 

This new solution is designed to help hospitals streamline their patient billing and collections processes. By capturing billing, claim and payment information, Centraspect HC for Revenue Cycle Management is able to deliver it in a single, unified view to support hospitals’ efforts in expediting the billing cycle.

 

This virtual view of a patient’s complete financial history is provided by Systemware in order to enable accounting personnel to accelerate cash collections, facilitate efficient billing processes and reduce patient billing processing costs.

 

An outside view into the medical industry indicates that hospitals are continuing to face increasing economic, competitive and regulatory pressures. As a result, there is an intense emphasis to begin the billing process sooner, generate initial and secondary claims more quickly, while also increasing overall operations efficiencies within the business office.

 

Gordon Sellers, director of healthcare solutions, Systemware, noted that in order to reduce write-offs, hospitals must be able to capture and present billable charges, generate more clean claims and process payments more quickly and efficiently than in the past. Systemware’s Revenue Cycle Management applications provide the solutions to meet these revenue objectives.

 

Sellers went on to add that through integration and extensive data management facilities, Systemware’s solution works in tandem with the hospital’s existing claims and billing system to provide a complete and accurate view of key patient data to support effective billing practices.

Centraspect HC for Revenue Cycle Management will be positioned using the following key features:

 

·   Automates claims payment posting process through support for automated workflow and ANSI EDI 835 formatted EOBs.

·   Integrates with existing claims system.

·   Security and compliance is assured through role-based access by user.

·   A logical view of all patient information is provided, including claims, EOBs, secondary claims and correspondence that are organized in a virtual patient chart.

·   All documents are contained in a single, scalable repository with detailed indexing; this includes all claims, EOBs, check images and supporting documentation.

·   Operational bottlenecks and financial impact are highlighted through the display of operations and executive RCM dashboards.

·   Call center support is facilitated in order to provide faster action on patient and provider inquiries.

 

Centraspect HC for Revenue Cycle Management is intended to be used in the business office by patient accounting to capture all documents and data associated with any explanation of benefits (EOBs) and electronic remittance advice (ERAs) and is integrated with a hospital’s current claims and billing system to allow for line-item level reconciliation of outstanding claims.

In the event of the submission of a secondary claim, an image of the primary EOB can be attached as required to that submission. This application is designed to facilitate the rapid scanning of documents or acceptance of 835s from lockboxes and payors. The application also speeds payment posting to increase throughput and reduce costs associated with possessing.

Centraspect HC for Revenue Cycle Management is not intended to replace a hospital’s claims and billing system. Instead, it is meant to sit beside the system to speed the capture of EOB and remittance data through the automation of many current manual steps. One of the resulting benefits to the hospital is that it will require a smaller payment posting staff to operate a more efficient accounting group. In addition, more payments can be straight through processes and secondary claims can be generated more quickly, reducing accounts receivable days outstanding.    

While many of us do not welcome the idea of hospital bills reaching us faster, it is most likely true that many of us forget certain applicable details by the time we receive a final bill after our insurance company has completed things on their end. Arguing an incorrect item on a statement proves to be a challenge when the statement isn’t received until months after the incident occurred.

 

This delay is detrimental for the hospital as well. And, not because they have to deal with complaints from patients, but because they have to wait so long to be paid for services rendered. Hospitals have expenses that must be covered and to do so, they must be able to collect on revenues generated. Systemware is offering these organizations a more efficient way to complete this process.