Revenue Cycle Management

Broadview Health's Revenue Cycle Management team will help you take control of claims management processes and your entire practice workflow. Our billing and coding services eliminate unnecessary claim denials and delays through a complete integration of workflow, billing and reimbursement management. Along with a powerful electronic medical records package, this enables us to communicate effectively with your staff and third party payors. Clean claims and a practice-specific rules engine will dramatically increase your bottom line.

Some of they key services we provide are:

• Superbill Redesign
• Fee Schedule Review
• Coding & Abstracting
• Patient Registration
• Insurance Verification
• Charge Entry
• Electronic Claims Submission
• Payment Posting
• Monthly Reporting/Financial Review
• Patient Statement Generation
• Semi-annual E/M Chart Review
• Benchmarking
• A/R "Clean-up" Program
• Spindown Projects

We provide full workflow management, including online access to the provider's office for patients, scheduling, document management, scanning, document routing, pharmacy callbacks, electronic fee tickets, electronic medical records, recall, etc. BroadviewHealth is staffed by professional coders to maintain the database and communicate with you regarding payor-specific, practice-specific and patient-specific information by CPT code. This produces extremely comprehensive, client-specific data that ensures clean claims and corporate compliance.

Our real-time rules engine updates CCI edits, bundling and LMRP updates, and searches for diagnosis compatibility.

Eligibility verification services are available, based on payor specific capabilities and access.

Broadview Health's Revenue Cycle Management team creates the charge in the system after review and verification of the coded charges by Certified Professional Coders. The center submits insurance claims to the appropriate payors, generates periodic patient statements, and maintains data files. All claims are submitted electronically, except for those payors who do not accept electronic claim submissions or appealed claims that require additional documentation.

Broadview Health's Revenue Cycle Management team allocates payments, denials and denial codes, and determines appeals in payment variance from negotiated contract to actual insurance payment.

Our team of reimbursement specialists follows every claim from submission to adjudication, ensuring proper handling of each submitted claim.

Claims status is tracked online and in real-time for continued reimbursement management. Claims submission dates, re-filing, as well as follow-up billing and collection notes are recorded and monitored by the billing staff, who are accountable for all activity in the system.

Reimbursement specialists promptly follow up on claims when payors fail to adjudicate within the specified time frame. At the same time, the center researches denied claims, re-files and updates the practice's internal database to alert staff to changes in payor requirements.

Broadview Health's Revenue Cycle Management team has online and immediate access to information requested by payors. This helps expedite claims adjudication with minimal interruption to the practice.

Contract and fee schedule management tools provide a detailed picture of the accounts receivable for the practice, including the variance between scheduled and actual payments. These tools help the provider ensure that accurate and appropriate payments are received.

Tracking and management of denied claims helps uncover deficiencies in coding and billing practices. Denial management is used as a tool for the provider or office staff to address coding and billing errors and inconsistencies up-front, instead of correcting a denied claim. Clean claims translate to quicker, more complete payments and an improved bottom line.

The reporting package is developed and customized for each practice, based on the requirements and objectives of the physician(s) and administrative staff. Once in place, the system emails periodic reports to the appropriate recipients, including physicians, administrative staff and any outside parties such as the practice accountant.

Our background and expertise in practice management separates us from typical billing companies, and means that we will be more successful in collecting the revenue that you deserve.

Our team of professional billing consultants includes experienced private practice managers, reimbursement specialists, and seasoned physician billing staff. These professionals all work together to ensure that our billing clients receive the highest level of service they deserve.

We work with each new client to develop an approach that works best for their practice. We realize and understand that no two practices are exactly the same.

Depending on your needs, we will design an approach that maximizes the efficiency of you and your staff, as well as our billing staff, and ensures the highest levels of collection. Some of our clients wish to continue entering patient demographic information in the office, and outsource the actual billing and collection efforts, while other clients prefer to simply "batch" all demographic and billing information and submit it to us for entry. We provide our clients with prepaid mailing envelopes in which to send us their documents or setup a electronic data transfer process.

We have a seasoned team of employees who have worked on various billing platforms and specialties and have resolved numerous datasets for different clients. Our experienced team and advanced quality compliance takes care of similar errors making the claims cycle smooth.