Sharp Revenue Tools
Uncover More Revenue and Shrink AR By Knowing Your Patients Financially
Healthcare billing departments struggle to obtain complete, accurate, patient financial data needed to optimize accounts receivable (AR). Missing or inaccurate patient information causes claim denials, payment delays, escalating receivables, self-pay misclassifications, and unnecessary write-offs. The influx of high deductible health plans, Medicaid and self-pay patients increases insurance discovery and verification challenges making maximum revenue capture more difficult than ever before. Significant revenue goes uncollected, costing millions of dollars annually.
The Sharp Revenue Modules fix cash flow leaks by finding up-to-date patient information. Lets you skip tracing and hunting payer websites saving time.
A single click and our modules automate while integrating multiple data sources to discover:
- Complete demographics
- Active coverage
- Federal Poverty Level/charitable qualifications
- Deductible management
- Propensity to pay keeping your organization 501r complainant.
With minimal effort, billers can conduct financial diagnostics on individual patients to yield maximum impact — truly optimizing their accounts receivable!
Capabilities
- Find missing demographics and active coverage
- Identify the correct responsible party the first time
- Verify prior authorization requirements and check deductibles
- Determine patient propensity to pay
- Qualify self-pay patients for charity or hardship
Benefits
- Recognize up to 12% increased revenue
- Realize upwards of a 6:1 return on investment
- Reduce returned mail due to more accurate demographic information
- Lower operational costs with increased margin
- Minimize write-offs and third-party agencies
The Eligibility Check module works to identify active, billable coverage and includes service type, co-pay, deductible and available coordination of benefits detail. We combine the latest technology with healthcare industry receivables expertise to quickly and effectively triage your patients’ insurance coverage. Fewer claim denials and improperly classified patients, new payer sources, and higher clean claim rates boost the bottom line.
The Insurance Discovery model combines the best technology with human intelligence to capitalize on every inquiry and explore every coverage option, including results with undetermined outcomes. We examine claims and clearinghouses at multiple levels to find every possible payer source.
The Prior Authorization module accelerates the process from provider order through prior authorization (PA) adjudication, saving valuable time. Automated PA provides efficiency, predictability, and cost savings that beat the manual approach.
Any provider or billing software vendor can automatically identify and convert an individual HICN or SSN to MBI. The MBI lookup tool accelerates what is otherwise a time-consuming, manual process and automatically facilitates clean claims and optimum reimbursement.
Demographic Verifier evaluates provided patient demographic information for accuracy by verifying or correcting patient name, address, date of birth, and phone number in real-time or batch processing. In addition, we will find any missing data points which, in turn, increases Insurance Discovery hit rates and lowers your returned mail. Available in real-time or batch processing.