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re|grip

Guaranteed Revenue Improvement Program

Overview

Using a comprehensive initial assessment of the revenue cycle, re|solution identifies areas where the facility has not received the reimbursement for which it is entitled. The assessment looks at all phases of the revenue cycle including: scheduling, registration, charge capture, coding, billing, collections and reimbursement. The assessment will identify claims to be rebilled, changes in process that will generate additional dollars and other opportunities to move towards a best practices revenue cycle. re|solution guarantees that the cost of the assessment will be covered by opportunities found for additional reimbursement.

Once the initial assessment is completed, re|solution works with two areas each quarter to assist them in improving charge capture, documentation and coding practices to insure that the facility is being paid the correct amount for all services that are performed. In addition, for a year following the assessment, re|solution will monitor the implementation of each recommendation to insure effective implementation. Once again, re|solution guarantees that the cost of this quarterly implementation and monitoring is covered by additional reimbursement.

Challenge

The challenges faced by rural and community hospitals are enormous. The same charge capture, coding and reimbursement issues that plague larger facilities also affect rural and community hospitals with less resources to insure compliance and appropriate reimbursement for services provided. re|solution’s re|grip program provides a safety net to insure that the provider receives all the monies they are due.  

Solution

Using proprietary technology, interviews and a proven continuous improvement and monitoring process, this no-risk program allows personnel at the departmental level to work with the revenue cycle personnel in optimizing reimbursement. This is the key to an effective revenue cycle when you can get the clinicians and the business people working together. The process also allows the facility to explore other opportunities for improvement such as point of service collections, denial management, self pay management, contract payment review and EHR implementation for meaningful use. This safety net gives our clients the peace of mind that all services are being reimbursed at an appropriate level.

Results

A Guaranteed Revenue Improvement Program. re|solution guarantees that the cost of this quarterly implementation and monitoring is covered by additional reimbursement