Zero-Balance Claims Reviews – a critical backstop for AR management strategies

Four Steps to Improving Collections Through an External Zero-Balance Review

Most healthcare systems or organizations typically don’t have the time, resources or expertise to conduct in-depth reviews of denied or unpaid aged claims. However, zero-balance reviews of closed balance accounts performed by an experienced partner represent a final safety net at the end of the revenue cycle management process that’s been shown to generate hundreds of millions of dollars annually for hospitals and health systems.
Learn about the four primary steps that should be included in a zero-balance review:

  1. Scrutinize contracts
  2. Evaluate discharge files
  3. Perform in-depth, 360-degree review
  4. Recommend improvements

Learn how you can bring additional revenue to your bottom line

Reclaim revenue you thought was lost through zero balance AR reviews. Once integrated into your hospital’s AR strategy, zero balance reviews will help bring additional revenue directly to your bottom line.
Pararev can help you progress toward the goal of zero-percent write-offs through our comprehensive AR solutions. We’re able to resolve all claims, regardless of size or age quickly, and conduct zero-balance claims reviews and root cause analysis to ensure you’re collecting every dollar you deserve. Contact us today to learn more.

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Revenue Cycle Executive Game Plan: Proven Automation Strategies that Deliver Results

Harness the power of automation

whitepaper cover page

Healthcare leaders can no longer expect traditional revenue cycle processes to produce the desired outcomes. To maximize cash flow, hospitals must instead harness automation and advanced analytics to augment their existing approaches at each step of the revenue cycle which includes:

  1. Price optimization and transparency
  2. Automated denial management and process flow
  3. Root cause analysis
  4. Division of labor
  5. AR strategies for aged accounts
  6. Zero-balance reviews of closed balance accounts

Developing an end-to-end action plan—from pricing through closed-claims audits—can help transform revenue cycle operations.

Optimize revenue and reduce leakage with ParaRev services and software

ParaRev offers a full spectrum of healthcare revenue cycle management services, from front-end charge master analysis and contract management to end-of-cycle zero-balance denial recovery.

ParaRev’s comprehensive capabilities, when aligned with hospital internal teams, can help hospitals improve operating margins and collect additional revenue.

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4 Strategic Area to Mitigate Revenue Loss – Quickly Adapting to Lost Revenue as Pandemic Rolls On

Organizations Need to Position Themselves for an Unknown Future

Whether, and to what extent, the industry can return to its pre-pandemic state remains unknown. But rather than simply waiting and hoping for the best, this whitepaper discusses four key areas hospitals can address right now to mitigate or reverse revenue losses:

  1. Staffing: sustaining consistent patient financial services amid staffing shortages
  2. Utilization and Payor Mix: understanding the shifting payor mix
  3. Ensuring optimal reimbursement: monitoring metrics to ensure claims are not denied or left unpaid
  4. Pricing: establishing a market-based pricing strategy

A comprehensive solution

Let Pararev help your organization supplement any staffing shortages, stay on top of accounts receivable inventory, identify where and how to maximize revenue and, if not completed yet, implement a price transparency program. Pararev, with our suite of comprehensive services, can help your organization overcome your financial challenges in 2021.

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Automation & Analytics in RCM

For hospitals and health systems, external forces are converging to make it increasingly difficult to consistently optimize revenue cycle management and sustain predictable cash flow.

During this webinar, we explore key areas where automation can improve your team’s performance, as well as where to apply visual deep dive analytics to stop revenue cycle problems before they even start.

Learning Objectives

  • Identify how to increase staff efficiency through automated decision-making of process flows and notation
  • Learn key denial-management and contract-management scorecard tips to identify hidden issues
  • Reinforce the importance of front-end revenue integrity programs and zero balance forensic retro analysis

Concerned about improving the quality of your AR processes?

With the ongoing shortage of skilled workers and the continuing struggle to maintain employee skill sets, it’s important to have all the tools needed to facilitate accurate payer reimbursement and help improve cash flow.

With the ongoing shortage of skilled workers and the continuing struggle to maintain employee skill sets, it’s important to have all the tools needed to facilitate accurate payer reimbursement and help improve cash flow.

HFRI offers a full spectrum of healthcare revenue cycle management services, from front-end charge master analysis and contract management to end-of-cycle zero-balance denial recovery. The company is committed to working seamlessly with hospital financial and billing staff to minimize denials and bad debt, improve collections and boost revenues. Our comprehensive capabilities, when aligned with hospital internal teams, can help hospitals improve operating margins and collect additional revenue.

Contact us today to learn how we can help your organization improve your financial outlook going into 2022.

Pararev offers a full spectrum of healthcare revenue cycle management services, from front-end charge master analysis and contract management to end-of-cycle zero-balance denial recovery. The company is committed to working seamlessly with hospital financial and billing staff to minimize denials and bad debt, improve collections and boost revenues. Our comprehensive capabilities, when aligned with hospital internal teams, can help hospitals improve operating margins and collect additional revenue.

Contact us today to learn how we can help your organization improve your financial outlook going into 2022.

Download the webinar replay by completing the form below:

Primary & Secondary AR Recovery and Resolution

Revenue Capture

ParaRev pursues your aging, small-balance claims identified by your staff as problematic. If a claim has previously been worked internally, referring it to ParaRev’s dedicated, specialized teams can help ensure quicker cash conversion and a reduction of bad debt reserves.

Primary AR recovery and resolution

ParaRev helps ensure hospitals and health systems quicker cash conversions and a reduction of bad debt reserves through a team of dedicated specialists combined with intelligent automation, our proprietary, next generation technology. ParaRev supports your specific AR requirements by working claims based on your processes – both small and high-balance claims as well as highly-aged claims. Our flexibility and scalability allow us to work in partnership with your CBO to recover and resolve all outstanding insurance claims based on your balance and age criteria.

Improve your AR with our core competencies:

  • Provide a virtual extension to bolster your central billing office’s resources with a dedicated, knowledgeable and responsive team of experts who have specific experience with your payers
  • Integrate seamlessly with your systems and sits on the background for ease of working relationship
  • Decrease cycle time through transformative intelligent automation and advanced business process engineering expertise
  • Ensure all claims, no matter age or balance, are effectively worked to 100% resolution utilizing appropriate staffing
  • Prevent future AR issues through proactive denial management using root cause analytics to identify and address problems at the source
  • Ensure the security of your PHI with HITRUST CSF certification

Pre write-off (Secondary) AR recovery and resolution

Hospitals and health systems are realizing that the highly-aged claims they would have written off, present a potentially major, untapped revenue stream. Also known as secondary assigned accounts or second placement AR services, pre write-off insurance collections provide a critical safeguard to ensure no insurance payments legitimately due the hospital go uncollected, regardless of age. Through a team of dedicated specialists combined with intelligent automation– our proprietary, next generation technology, ParaRev can efficiently pursue these claims and maximize cash returns.

Benefits of enlisting a pre write-off recovery partner:

  • The establishment of an AR management process that offers a systematic approach to obtaining 100% claims resolution
  • A reduction in write-offs, a commensurate increase in cash flow and a decrease in bad debt reserves caused by aging accounts
  • The creation of incentives that push primary AR vendors to optimize their processes
  • Greater transparency to enable hospitals to evaluate performance across the entire revenue cycle
  • Let ParaRev focus on those claims that are approaching the end of the typical recovery cycle to help you collect more cash.

Spot/cleanup projects

Revenue Capture

ParaRev is available to assist you as relief valve in multiple scenarios:

  • EMR conversion projects—Assist with legacy platform to ensure staff has priority focus on new platform, or vice versa
  • Fiscal year-end projects—Assist with achieving aging and cash goals
  • Overall spot projects—ParaRev is available to assist for assorted project needs that are not necessarily ongoing in nature
  • Test trial projects—Let ParaRev prove ourselves with a one-time project to show you what we can do

As a vendor, our goal is to be flexible and assist our clients however needed. Our goal is to prove through our technology and experience that we can be a true partner for any healthcare provider.

Legacy system conversions

Revenue Capture

For hospitals and health systems, replacing or upgrading an electronic health record (EHR) is a major undertaking fraught with operational and financial risk. Whether you’re upgrading your legacy system or integrating an acquisition into your current system, it’s essential that you ensure the smooth transition of clinical information, accurate coding, demographic, and financial data to sustain billing operations.

Supporting a seamless conversion requires extensive planning and training, along with laser-like focus on the operations and features of the new platform. Yet too often, billing personnel are pulled in multiple directions as they scramble to master the complexities of the new system while trying to wind down aging accounts receivable (AR) tied to the legacy platform. Attempting to juggle these competing duties can produce the worst of both worlds: The volume of outgoing claims submitted through the new system falls, while unresolved accounts in the old platform pile up. Cash flow erodes as days in AR and denials increase. And if unanticipated problems or delays emerge during the EHR implementation, the financial problems can quickly snowball.

ParaRev can help

  • Let us help you mitigate these risks and preserve cash flow by handling the legacy accounts, allowing internal staff to concentrate solely on handling new system billing activities. By focusing just on the new system, in-house personnel can more quickly develop the skills and knowledge necessary to assemble and submit claims in an accurate and expeditious manner.
  • Do you have times where you have a backlog of old accounts? ParaRev can help you here, too by deploying a team of experts to help you clean up these episodic backlogs.
  • With ParaRev as your partner you can be assured that all aging denials are worked methodically and completely to resolution. That means cash can be collected on accounts that otherwise would likely have been written off.

Specialized payer resolution

Revenue Capture

ParaRev has experience handling all situations and all payers, and can take on any long-term or temporary AR projects you have in mind and will improve reimbursement, reduce denials, and decrease audits.

Our expertise ranges from:

  • Clinical denials (including prior authorization and medical necessity), handled by the expert RN staff of our utilization team
  • Coding and billing issues, resolved by our certified coders
  • Workers Comp/Personal Injury, handled by our specialized WC/PI team
  • COBs and patient denials
  • High- and low-balance account resolution
  • Aged problematic accounts and backlogs
  • Appeals
  • Corrected claims and rebills
  • Fiscal year-end collections

Targeted denial resolution

Revenue Capture

ParaRev has over 20 years of AR and denial management resolution experience.

  • Our system and our processes are what sets us apart from other AR firms.
  • Our system is an automated decision tree, driven by our clients’ desk procedures and years of experienced industry-leading solution best practices. This platform is driven off EDI analytics, which starts an FTE at the appropriate initial step to expedite resolution.
    • Once a person is set at the correct initial starting point, the system guides them step-by-step through the resolution process of that issue, forcing the correct action to be taken.
    • Through this system, any type of issue or process can be streamlined for maximum efficiency.
  • Our workflow system keeps track of what needs to be done and when. Keeping our reimbursement specialists focused on what they need to accomplish and providing management the visibility into items that need action. Our system automatically sets reminders and ensures accounts get the required actions completed prior to timely filing.
  • ParaRev creates custom workflows for our individual clients based on their processes and procedures; our workflows will mirror your workflows. ParaRev creates these workflows for all major denials/issues; they are built into our software, ensuring your policies and best practices are followed. By guiding our staff through the best next steps within our software, we can ensure the highest levels of performance.
  • We have found that dedicated reps are far more productive than pooled staff. Working with a specific client not only gives them the ability to learn the client’s business & payer contracts, they also learn their culture and become experts on your specific collecting process, as every client is different. Along with dedicated team members performing follow up, ParaRev provides dedicated managers, supervisors, and team leads to your account—available whenever you need their expertise or insight.
  • Problem identification and communication is key. All of the above processes provide us with a tremendous amount of information. This information is then analyzed and provided to our clients in the form of dashboards, monthly reports, and quarterly meetings, including recurring deep-dive analytic presentations from subject-matter experts that will uncover root causes driving AR issues.  This information often results in helping our client strategically improve their revenue cycle by identifying front-end, system/edit, and payor-related opportunities.  By partnering with ParaRev your operation typically will see improved collections and reduced aging on the subset of the accounts outsourced. This is due to our process and the fact that we would be applying more attention to a targeted area of accounts that may not have historically seen as much focus. Our goal is to be a relief valve and allow your internal staff to target the younger inventory in other areas that need attention.

Underpayment Recovery

Revenue Capture

Behind robust contract management systems, strong front line PFS staff, and third-party vendors, PARAREV’s STAT Revenue team collects millions of underpaid commercial and government insurance dollars. We go account by account to find your unique underpayment issues that are often missed by technology-based vendors. We get you every dime you’re due.

In our experience 1% of contractually due revenue will go unpaid, which could be a million-dollar mistake.

Our nationwide revenue cycle expertise combined with our in-depth knowledge of payer and coding issues enables us to quickly recover lost revenue. Even when working behind robust contract management systems, strong front-line PFS, or other third-party vendors, we ALWAYS deliver results. We work on a full contingency basis so we only get paid if you do.

Our uniquely tailored independent payment audit does not rely on software on top of software to identify underpayments. Programs have intrinsic limitations when dealing with complex reimbursement methodologies. Our approach gives us the flexibility to address your hospital’s unique underpayment issues often missed by technology-based vendors. Our human-based approach, combined with our proprietary database, makes for an incredibly strong review that consistently outperforms even the best contract management systems.

Once underpayments are identified and researched, our highly skilled team works on your behalf to collect that revenue from your payers. Our proven follow-up, appeals, and denials approach consistently results in collections for even the most challenging underpayment issues.