Revenue Cycle Management: Healthcare Industry Seeing an Up-Tick in Outsourcing Partnerships

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Revenue Cycle Management
Healthcare Industry Seeing an Up-Tick in
Outsourcing Partnerships
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S T R O N G
Revenue Cycle Management
Hospitals and healthcare organizations are
turning more to outsourcing partnerships for
revenue cycle management. As healthcare
providers realize they lack the required in-house
expertise and resources, outsourcing providers
have a significant opportunity to build
mutually-beneficial relationships. This trend
will only grow as healthcare providers are
pressured to reduce operating costs and have to
deal with lower reimbursement rates.   Based on
recent reports, it appears everyone wins when
hospitals and healthcare providers outsource.
The hospitals can streamline costs and boost
revenues. With more efficient cost and revenue
management, they can focus on providing better
care to patients. And, revenue cycle management
providers can grow their businesses.
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S T R O N G
Revenue Cycle Management
According to Modern Healthcares annual
outsourcing survey, the top 20 healthcare
outsourcing companies grew their businesses by
13.1 between 2010 and 2011. Collectively,
this group of 20 outsourcers served 16,463 total
healthcare clients in 2011. This figure
represents an increase over the 14,556 reported
in 2010.   Another interesting note about this
study is the size of healthcare organization
using outsourcing. In the past, typically
smaller hospitals enlisted outsourcing services.
Today, however, larger hospitals are realizing
they can stay ahead of the curve by shifting some
responsibilities, like revenue cycle management,
to an outsourcing provider.
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S T R O N G
Revenue Cycle Management
Why the Focus on Revenue Cycle Management?

• Tighter reimbursement environments and constantly
  evolving technologies are prompting hospitals to
  seek outsourcing partnerships. Healthcare
  providers must be diligent about collecting the
  most money for the services they deliver.
• Outsourcing providers that specialize in revenue
  cycle management can help hospitals get paid on
  managed care contracts, as well as minimize bad
  debt.
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• Revenue cycle management represents a high-growth
  business for healthcare outsourcing providers.
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• This jump in outsourcing is encouraging given
  many hospitals in the past have approached this
  model reluctantly. However, revenue cycle
  management, cost cutting and other financial
  considerations have made outsourcing a viable and
  accepted practice.

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S T R O N G
Revenue Cycle Management
Why the Focus on Revenue Cycle Management?

• In addition to improving financial metrics and
  revenue cycle management, outsourcing providers
  can offer advanced technologies to hospitals. An
  outsourcing company can, in essence, play the
  role of chief technology officer for a hospital.
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• Each hospital can decide how best to partner with
  outsourcing firms for revenue cycle management.
  
• One benefit of these partnerships is flexibility.
  Each partnership can be tailored to the exact
  requirements of the hospital. Outsourcing
  providers can play a consulting role or manage
  entire processes for a hospital.

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S T R O N G
Revenue Cycle Management
Revenue Cycle Management and Other Patient
Financial Services by Pyramid Healthcare Solutions
Early Out ServicesInsurance and Self Pay.
Through a team-oriented approach, Pyramid
tailors solutions to generate maximum cash
collections. Pyramid accepts and resolves
accounts of all ages, from day one to aged
receivables.   Accounts Receivable Wind Down and
Data Archiving. Pyramid combines highly trained
staff specializing in A/R liquidation and cash
acceleration with an active data archiving
technology solution.   Aged Accounts Receivable
Clean-Up and Cash Acceleration. Pyramid offers
an onsite, remote or blended delivery model to
assist in cleaning up aged receivables. A/R
follow-up experts analyze the aged A/R,
prioritize it, and use a variety of tools to
collect cash as quickly and efficiently as
possible. Pyramid will also categorize reasons
for non-payment, payment delays and denials.
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S T R O N G
Revenue Cycle Management
Revenue Cycle Management and Other Patient
Financial Services by Pyramid Healthcare Solutions
Business Office Outsourcing and Medical Billing
Services. Using a partnering approach, Pyramid
bills, follow-ups and collects hospital accounts
receivable (A/R). We work with clients to
establish cash flow and A/R balance goals and
address the sensitive issue of what to do with
the current employed staff.   Operational
Assessments, Action Plan Development and
Implementation Assistance. Pyramid conducts an
analysis and reports findings detailing the
underlying reasons for any performance issues.
We also include action plans and recommendations
for improvement.   Accounts Receivable Management
Training. Pyramid provides one-on-one
instruction to the new or less experienced PFS
Director. A proven expert with direct experience
in managing hospital revenue cycle operations
provides the training.
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S T R O N G
Revenue Cycle Management
Revenue Cycle Management and Other Patient
Financial Services by Pyramid Healthcare Solutions
Interim Staffing. Pyramid offers a variety of
seasoned leaders such as CFOs, CIOs, Patient
Access Directors, Business Office Directors,
Reimbursement Directors and others to supplement
your staffing requirements. Our staff members
typically have over 20 years of experience.
  Credit Balance Adjudication. Pyramid offers
a skilled credit balance staff so a hospitals
more experienced collectors can focus on cash
collections. We also help bring a facility into
compliance.   Specialty Services. Pyramids
highly trained staff offers Home Infusion
Collection Services including patient accounts,
infusion, home health therapy and Durable Medical
Equipment. We also provide Medicaid Eligibility
Advocacy Services. Pyramids professionals know
how to review, screen and process uninsured
patient accounts to recover untapped
reimbursement dollars.
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Revenue Cycle Management
ABOUT THE AUTHOR
Nav Ranajee is VP of sales and marketing for
Pyramid Health Solutions, a provider of complete
revenue cycle services. Learn more about
Revenue Cycle Management by visiting
http//www.pyramidhs.com.
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THANK YOU
STRONG
STABLE
STRATEGIC
Trusted Revenue Cycle Partner Since 1985
800.927.8435 Email info_at_pyramidhs.com
Website www.pyramidhs.com