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Revenue Cycle Management  

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  • Revenue Cycle Management  

    • Revenue Cycle Management

    We provide a collaborative management approach with the client, where All Covered assumes full responsibility and control of the whole revenue cycle process from end to end. For these situations, All Covered is responsible for attaining mutually agreed upon revenue-cycle performance goals by coordinating with the provider’s staff.We also offer a complete partnership in which we acquire the employees of a client. As a true risk-sharing partner, in this arrangement we join forces with the client, and take full responsibility for a company’s revenue cycle processes. At All Covered, we work through your existing accounts receivable balances, helping you capture revenue both prior to and after system conversion, while your staff focuses on the new system.

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    By the Numbers

    • 30% of denials are due to registration and pre-service errors
    • 55% of patient financial responsibilities are never recovered
    • $25 is the average cost to re-work one denied claim

    Service Details

    Patient Access

    Complete front-end service and support for all processes, including pre-registration, eligibility and benefits, prior approvals, release of information and financial counseling.

    Services include: Pre-registration, patient calls, no-show management, appointment reminders, form digitalization, scheduling, financial counseling, insurance verification, collections, POS payment posting, authorizations/referrals and pre-certs, medical records and release of information.

    Provider Management & Contracting

    A complete provider management platform that can deliver on every aspect of enrollment, privileging and credentialing. Top-notch evaluation of payer contracts with payment versus contractual analysis.

    Services include: Privileging, payer enrollment, provider credentialing, facility credentialing, licensing, EDI/ERA/EFT enrollment, contract management, contract review, contract renegotiation and contractual payment analysis.

    Billing

    Full service, back end solution with appeals and denials management that provides transparency at every level. Optimized and accurate coding with auditing processes to improve compliance, reduce denials and increase revenue.

    Services include: Charge capture, coding, claim scrubbing and claim submission.

    Quality Payment Program

    Analytical evaluation of your unique, and standard, performance measures with metric tracking and reporting capabilities

    Services include: Charge capture, coding, claim scrubbing and then claim submission.

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    A/R Management

    Timely and efficient A/R account follow-up to reduce denials, improve transparency and maximize your reimbursement.

    Services include: A/R analytics, denial management, claims follow-up, state-specific capitation, appeals management and bad debt management.

    Cash Management

    Efficient cash management processes for reconciliation, lockbox management, payment posting, refunds and collections to improve profitability.

    Services include: Cash reconciliation, month-end process, payer takebacks, patient refunds, lockbox management and patient statement services.

    Data Migration Services

    Successful data migration helping your organization move data from one system to another. Our experts use efficient methodologies to seamlessly move data to meet your business needs.

    Utilization Review/Case Management

    Full retrospective assessment that can provide claim submission, coding and accurate billing review for services rendered.

    Services include: Retrospective assessments and discharge planning.

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    Advisory Services & Training

    Our comprehensive analysis can assist with current workflow and process improvement, identify positive or troublesome trends, and increase revenue and productivity while also increasing both patient and client satisfaction. State of the art training is available to maximize efficiency, revenue and overall satisfaction.

    Services include: Consulting, spreadsheet and document data consolidation, KPI assessment and management. RCM/Back-end collection, front end activities, billing transactions, CDI (clinical documentation), coding, cash management, underpayment recovery and chart auditing.

    Auditing

    Pre-audit review, auditing services and audit results provide an in-depth report with recommendations for improvement.

    Services include: RCM/Back-end collection, front end activities, billing transactions, CDI (clinical documentation), coding, cash management, underpayment recovery and chart auditing.

    Compliance

    HIPAA Assessment: Our assessment methodology will ensure an efficient, effective security audit based on current HIPAA regulations and the OIG current year work plan. In addition to HIPAA and HITECH, All Covered can assess for additional compliance framework like ISO 27001 – 27002, NIST 800-53, NIST CSF, Cybersecurity Capability Maturity Model (C2M2), PCI DSS and FFIEC.

    Value-Based Care

    Providing patient care that matters requires a comprehensive approach to understanding an individual’s care needs, while understanding the patient population as a whole. The shift to value-based care – keeping people healthy by focusing on patient outcomes and improving quality of care – holds the key to bending the cost curve. Most high-value patient data is hidden in unstructured data, which can be difficult to extract and process at scale. Our end-to-end Value-Based Care Solution turns structured and unstructured patient data into insights in real time. The platform has been designed to help providers and healthcare teams better predict and manage patient.