As payment models shift with the evolution of value-based care, SSI provides solutions that allow organizations to become more diligent in protecting revenue and capitalizing on every collection opportunity.
Payers try to take 3 – 5% of contract value every year.
-Eliciting Insights – Market Research
While additional information is a major source of pending or denied claims, most providers and payers currently use a paper process to request documentation to support a claim. This practice can create significant delays, especially with mail time and the risk of lost attachments. SSI Attachment Processing allows for electronic submission of claims and attachments, along with end-to-end tracking, to provide a unified workflow across a distributed response team. Users can ensure timely filing, eliminate shipping costs, and get paid faster than with paper processes.
SSI Attachment Processing allows providers to completely automate the delivery of most any type of attachment via a secure Web portal. Get paid faster with use of this solution – typically within 15 days.
With SSI Attachment Processing, your organization, can:
- Add electronic attachments while editing claims
- Quickly attach images by scanning, importing or utilizing direct print capabilities
- Automatically add Additional Development Requests (ADR) from Medicare’s Common Working File (CWF) as a request for attachment and process them electronically
- Eliminate the need to mail paper claims and thus eliminate shipping costs
- Transmit ADRs and attachments back to the contractor electronically via the esMD Gateway
- Receive 277 statusing of claims and attachments back into both the attachment and billing portals for easy tracking
Administrative costs for providers account for over a quarter of total expenditures, with a significant share of this spending attributed to paperwork associated with billing, coding, insurance and the like. Regulations within the industry add an additional layer of complexity. In order to successful manage revenue cycle operations, providers today must digitize documents instead of relying on manual, paper-based processes. By adopting a document management system, organizations can cut spending, establish greater security and compliance, and achieve faster processing with few errors.
SSI Document Management is an enterprise content management solution organizations can use to conduct business by shifting from paper-based to electronic document processing. The solution can benefit almost any area of the revenue cycle, and easily integrates with existing systems to provide a seamless process for the various departments within an organization. Through customizable workflows, Document Management makes it easy for documents to move instantly from one business area to another, eliminating interoffice mail delays and lost documents. With Document Management, necessary information is available to users simply with the touch of a few keys.
With SSI Document Management, your organization, can:
- Streamline business office, admissions, medical records and registration department workflows
- Reduce the costs and delays associated with document handling, storage and retrieval
- Automate the process of requesting, capturing, filing and sending documents
- Retrieve necessary information instantly
Convoluted payment terms, complicated contractual jargon, emerging payment models – payer practices in today’s healthcare landscape are certainly not designed for easy or accurate payment to providers. With SSI Contract Management, providers can hold payers accountable for their contractual obligations and protect revenue otherwise at risk. Using this tool, healthcare organizations can more accurately collect from payers and forecast future revenue impact to appropriately prepare for, or negotiate, changes.
SSI Contract Management is a robust solution that automatically reviews for payment accuracy and updates, based on user-defined rules built into the system. Users have the means to easily and graphically model contracts through simple drag-and-drop functionality. Additionally, the system’s forecasting capabilities enable providers to foresee the impact of proposed contract changes on their revenue.
With SSI Contract Management, your organization can:
- Understand the payments that should be received based on contract terms
- Ensure proper payment from payers
- Strategize for payer contract negotiation
- Plan for revenue impact of proposed contract changes
- Identify and recover underpaid reimbursements
The recent rise in regulatory and commercial payer audits threatens providers’ revenue and creates costly administrative burdens for facilities. Using Audit Management, providers can ensure timely filing with a workflow tool that tracks existing, and incoming, audits and protects revenue with complete visibility into audit-associated revenue risks. By adopting an offensive approach to the audit process, healthcare organizations can conquer audits and minimize the impact on their bottom line.
Using SSI Audit Management, providers can ensure timely filing with a workflow tool that tracks existing, and incoming, audits and protects revenue with complete visibility into associated revenue risks. With the solution, audit requests can be moved electronically to various departments within an organization, while supporting documents can be scanned and attached.
With SSI Audit Management, your organization can:
- Quantify risk and gain insight into the root cause of problems
- Reduce future take-backs and protect revenue
- Automate workflow to simplify compliance with audit requests
- Accelerate audit resolution by improving documentation requests and tracking documentation necessary for successful appeals
- Utilize electronic submission of medical documentation (esMD)
With mounting pressure on healthcare providers’ margins, it is necessary for facilities to evaluate – and fine-tune – their revenue cycle management. Analytics allows users to measure, identify, and improve upon strategic and operational performance goals, while fostering a deeper understanding of their organization’s key performance indicators (KPIs). Through reporting capabilities, providers can get a complete view of the revenue cycle to accelerate cash flow and address their most critical challenges.
With SSI Analytics, providers can achieve the visibility necessary for decision makers to hone in on their organization’s primary revenue cycle drivers with specific, customized views based on their interests. The application helps answer many of the critical questions that lead to process improvement and provides direction regarding the future opportunities that should be pursued.
With SSI Analytics, your organization can:
- Perform ad hoc analysis with limitless reporting and charting options
- Gain quick access to critical KPIs to analyze financial performance
- Automate complex tasks
- Attain information for staff performance and accountability
- Identify the root cause of trends for appropriate upstream correction