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of people, processes, and technology
SSI’s Professional Services team is a group of highly qualified revenue cycle consultants who travel on-site to probe deeply into a client’s revenue cycle operations. While the engagement type dictates the overall agenda, the details of every visit are tailored to the unique needs of each client organization. The group’s advanced product knowledge, coupled with its access to SSI service and engineering teams, allows them to take a responsive, holistic approach to the revenue cycle.
Revenue Cycle Assessment
SSI’s Revenue Cycle Assessment is a review of client business processes, KPIs, technology and operational effectiveness in an effort to find waste and improve process efficiency. This includes evaluation of current SSI solutions, along with a discussion and recommendation of best practices. As a result, clients receive a revenue cycle roadmap that identifies immediate areas for improvement to help reduce revenue cycle labor and A/R days.
The Revenue Cycle Assessment provides organizations with:
- A complete overview of the revenue cycle from patient access to zero-balance claim status
- Review of key metrics, identification of system best-practices which should be adopted to reduce labor and improve cash flow
- Direct education and training of billers and billing managers in the effective utilization of SSI technology
Clean Claims Rate Optimization
The clean claim rate (CCR) is one of the most common operational metrics in revenue cycle. A low clean claim rate generally reflects weaknesses within the upstream systems and processes that generate the claim. SSI’s Clean Claim Rate Optimization engagement enables clients to identify and implement changes to minimize the errors that lead to a reduced CCR. Learn to appropriately restructure processes to eliminate unnecessary follow-up and reallocate resources to the items requiring the most attention.
The Clean Claims Rate Optimization engagement provides organizations with:
- A detailed analysis of their current Clean Claim Rate
- Categorization through root-cause analysis of top claim errors
- Resolution of edits that can be addressed through system or translator changes
- A governance process for sustaining and improving the clean claim rate
Secondary Billing Optimization
Secondary billing is a complex process that requires managing payer specification changes, resolving complex secondary payer edits, and properly linking remits to claims. With the SSI Secondary Billing Optimization engagement, SSI creates a clean process for clients to electronically bill secondary claims, with suggested enhancements to streamline the process.
Secondary Billing Optimization provides organizations with:
- Analysis of the secondary billing process according to payer
- Optimization of the upload process for linking remits to claims
- Reduction in the error rate generated by secondary claims
- The ability to minimize paper processing of secondary claims
SSI Application System Admin Service
SSI Application System Admin Services can bridge the gap, on an interim basis, when turnover occurs at an organization and providers are struggling to secure qualified staff and ensure they are trained properly. Through both remote and on-site training, the team provides end-user application support for an efficient SSI billing process and best practice operation of the SSI platform.
SSI Application System Admin Services provides organizations with:
- Interim system administration services to keep the revenue cycle operating
- Adoption of best-practices to minimize labor requirements
- Transitionary education for a new SSI application administrator or analyst during the learning curve stage
Patient Access Assessment
Bridging the gap between Patient Financial Services and Patient Access is critical to achieving an organization’s revenue cycle operational and financial objectives. SSI’s Patient Access Claims Denial Assessment is an engagement designed to perform deep analysis and correlate an organization’s claim denial data with its Patient Access processes. The focus of this assessment is to arm SSI clients with the data, processes and automation opportunities to help them reduce revenue leakage from upstream Patient Access functions.
The Patient Access Claims Denial Assessment provides organizations with:
- Root cause analysis of payer denials and rejections
- Data analysis for correlation of increased labor and tied-up working capital
- Process reviews to identify current environment against related Patient Access denials
- Review of workflow modifications and technology automation to achieve benchmark goals
- A best-practices roadmap for adopting meaningful improvements in each client’s unique environment
Contract Management Services
Effective utilization of SSI’s Contract Management platform comes only with a well-designed and effectively-modeled library of contracts. These models can be used for underpayment identification, negotiation of new contracts, or financial accrual analysis. SSI can provide a variety of contract modeling and payment analysis services for myriad contract management needs within an organization. Also receive an independent, technology-neutral assessment of overall contract management processes and identify opportunities for financial efficiency.
Contract Management services provides organizations with:
- Contract modeling of new or updated contracts (also available as a managed service)
- Payment analysis of specific payment variances
- Negotiation support for payer proposal analysis to assure a revenue-positive outcome
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