Hospital Revenue Cycle Management Services

While the complexity in generating revenue is increasing, hospitals are also facing a lot of pressure to reduce costs. Revenue cycle outsourcing is an area many health systems and hospitals have increased consideration for. Your core expertise lies in providing quality patient care. So, why not control costs by managing your expensive administrative functions? Additionally, your hospital revenue cycle management services partner will implement efficient billing processes, which will improve your reimbursement and assist you in maintaining a healthy cash flow.

Tracking critical KPIs can provide insight into the state of your revenue cycle. And that is exactly what we do! The health and success of your services relies considerably on the efficiency of your revenue cycle. Outsourcing your hospital billing services to 3Gen Consulting can help streamline your process. Swift collections and improved cash flow are ensured through our hospital revenue cycle management services. By integrating people, processes and technology, we can help you improve your system efficiencies, meet organizational needs and reduce operational cost.

Improve Collections. Reduce Costs.
Streamline Your Hospital Revenue Cycle Process.

Our Hospital Revenue Cycle Management Services

Our hospital revenue cycle management services can come in many forms, including end-to-end and co-sourcing, and are customized to your hospital or health system’s goals. We provide guidance in prioritizing your hospital KPIs and offer hospital billing services to improve the health of your revenue cycle. These solutions will help you streamline processes, reduce days in A/R, improve collections and reduce costs, all while remaining in compliance.

Insurance Eligibility Verification & Prior Authorization

To receive reimbursements for services provided, hospitals need to verify each patient’s eligibility and benefits before the patient visits. This helps determine information not only about insurance coverage, but also patient’s responsibility. Incorrect insurance information can result in delayed payments, rejected claims and delays in care provision. To improve your clean claim submissions, our team verifies coverage on all primary and secondary payers, follows-up with patients for any missing or incorrect information and initiates prior authorization requests and obtains treatment approvals, whenever required.

Patient Demographics Entry

Accurately capturing patient details in the demographic entry process is important as it forms the basis for the patient’s medical record. To facilitate quick claims processing, our team captures and validates patient details, payment information, insurance coverage and any additional medical information such as allergies, special requirements, etc.

Medical Coding & Coding Audits

Coding is a crucial component of the hospital billing process. Appropriate use of CPT, HCPCS, ICD codes and modifiers are critical for accurate reimbursement for all services rendered. Our certified coders are experienced across various specialties and care settings and are regularly educated on updated coding guidelines, to ensure high coding accuracy and to mitigate compliance risk. That’s not all! With a separate team of quality auditors, we have built audits into the process to ensure there is a comprehensive review of the services coded.

Charge Entry & Charge Audits

The charge entry process decides the reimbursement amount hospitals will receive from payers. The patient account value is assigned using the coded chart and appropriate fee schedule. Accuracy is key while processing charge entry transactions. Thus, we ensure effective collaboration between the coding and charge entry teams to make sure appropriate reimbursement is obtained. Our charge entry team captures patient demographic information, date and place of service, billing provider details, referring provider, admission date, prior authorization number, CPT/procedure codes, diagnosis codes, modifiers and number of units with exceptional accuracy. Charges are entered into the hospital’s system and reviewed for accuracy before claims are submitted to a clearinghouse. We also perform charge entry audits to identify missed charges, over-billing or coding errors, which would result in lost revenue.

Payment Posting

Our payment posting team does not just process payments, but analyzes reimbursement and denial trends to understand the effectiveness of your hospital’s revenue cycle. Our payment posting services include patient payment posting, electronic remittance advisory (ERA) posting, manual payment posting and denial posting.

Accounts Receivable Management

Accounts receivable management is an important part of the revenue cycle. Issues with AR will directly impact hospital’s margins, debt and organizational financial health. Our team will analyze your financials, identify errors and implement efficient processes to collect payments and clear backlogs of unresolved AR within a quick turnaround time. In short, you can trust us to convert your Receivables to Revenue.

Denial Management

Dealing with claim denials can be a cumbersome task. Access our expertise to streamline workflows for improved and efficient collections. Our team can help health systems and hospitals identify and correct root causes of denials, resolve underpayments, appeal denied claims and improve your financial performance.

Credit Balance Resolution

A credit balance is a liability in your accounts receivable ledger. Failure to address credit balance accounts can lead to compliance risks and penalties. With our credit balance resolution services, you will reduce financial liability, maintain the integrity of your revenue cycle and remain in regulatory compliance. Our team will analyze your credit balances, identify overpayments, correct errors and generate patient/insurance refund letters in a timely manner.

Avail 3Gen’s Hospital Revenue Cycle Management Services And Optimize Your Approach To Billing

The 3Gen Advantage

Partnering with 3Gen means having the opportunity to optimize your hospital revenue cycle. Our customizable and scalable solutions are curated to provide you with a comprehensive experience of greater efficiency and sustainable financial performance. Still not convinced? Here are some additional reasons to highlight the 3Gen hospital billing service difference.

Greater Processes

Billing can be overwhelming. Implementing a streamlined and compliant billing process is a daunting task. With our years of experience coupled with our understanding of the nuances of the healthcare regulatory environment, we devise strategies and processes to adapt to your hospital’s goals and help maximize reimbursements.

Greater Savings

Managing hospital billing in-house can be expensive. With our hospital billing services, you can save costs associated with this process such as salaries and benefits for staff, technology, hardware and training.

Greater Profits

Not only does outsourcing to us help you save costs, we also help accelerate your revenue through timely claim submissions and increased reimbursement. There’s no doubt that your hospital will improve their profitability.

Greater Talent

It is challenging to find enough qualified resources to get your claims out the door in an efficient and timely manner. We understand the importance of having the right people on the job. We provide you with access to scalable teams of skilled and experienced coding and billing professionals who remain updated with the changing healthcare regulatory environment and compliance requirements.

Greater Patient Care

Handling your billing in-house requires a lot of time and effort. Time and effort that could be directed towards your core expertise – patient care. Let us focus on your financial health, while you get to focus on your patients’ health.