Solution Components

Patient Access– The beginning of the revenue cycle in which the hospital makes first contact with the patient. Patient access services are critical to the revenue cycle because it is the first opportunity to get the billing information correct – garbage in... garbage out. In addition, collecting amounts due at the time of service can dramatically decrease the level of bad debt that is experienced on the back-end. PHNS outsourcing services include the following:

• Centralized call centers for scheduling and pre-registration processes
• Centralized and leveraged center for insurance verification and authorization processing
• Pre-registration and point of service registration portals and applications to ensure data integrity
• Customer relationship management applications to monitor call center activities and performance
• On-site management of patient registration processes and up-front cash collections
• Financial counseling services / vendor management

Health Information Management – The middle of the revenue cycle after the patient receives treatment, including chart completion, transcription, charge capture, diagnosis coding and release of information services, is critical to the billing and collection process both in accuracy and timeliness of completing the tasks. PHNS offers full HIM services which can be seen in detail under the HIM tab above.

Patient Accounting – The final component of the revenue cycle in which the business office begins editing the claims to ensure payment is expedited and finalizes the process with claim resolution is typically seen as the most important step in the revenue cycle. Clearly, the business office is very important, but the two previous revenue cycle areas and many other factors can impact the successful resolution of claims. PHNS outsourcing services include the following components performed in a leveraged and centralized facility:

• Claims editing and submission
• Online error and rejection processing
• AR collection and follow-up services for all payer categories
• Correspondence processing
• Online denial management
• Payment and adjusting posting via electronic processing, as available
• Contract compliance to ensure accurate reimbursement
• Appeals processing
• Patient contact center (inbound and outbound call center)
• Receivables management services (collection programs)