Post Care - Revenue Management

Patient Billing /Receivables Management

Our Patient Accounting solution makes Patient Revenue Management easy by automating patient billing, follow-up, and collections while achieving best-practice receivables management key performance indicators.

With these efficient, flexible solutions that provide the foundation for billing and receivables management, you can produce clean claims on the first try, reducing your cost to collect and minimizing costly reworking of denials. The core billing functionality enables you to run claim information against CMS edits and allows you to resolve issues prior to billing. With embedded Electronic Data Interchange (EDI) capabilities, Patient Accounting, with its Affinity technology platform, automates billing and follow-up activities using the transaction sets standardized and mandated by HIPPA.

As a single integrated solution tying together Access Management, HIM, EDI, and rules-based, exception-driven workflow, Affinity Patient Accounting gives you the tools you need to efficiently and effectively manage your billing and receivables management.

Benefits

  • Create clean claims more quickly, improving cash flow
  • Achieve best practice revenue cycle metrics
  • Improve efficiency through exception-driven workflow
  • Reduce cost to collect with embedded EDI and clean claim tools
  • Bill for long term care patients
  • Guarantor Control Panel enables guarantor level views with account management tools
  • Guarantor billing consolidates multiple accounts onto one statement
  • Reduce need for “bolt on” solutions

Electronic Data Interchange

Achieve substantial cost savings by connecting directly to payers instead of sending all transactions to a clearinghouse with HIPAA-mandated EDI transaction sets fully embedded into the core patient accounting and patient access functions.

Using HIPAA-mandated transaction sets, you can ensure patient payment information is gathered up front. Additionally, EDI helps to automate activities such as checking on the status of claims, which improves efficiency and reduces costs.

Benefits

  • Expedite information exchange with payers and clearinghouses
  • Automate in Registration the checking of eligibility information
  • Improve efficiency using workflow driven by the transaction sets
  • Denial management analysis driven by EDI content

Early Out Receivables Management

Affinity Extended Receivables Management (ERM) boosts Patient Accounting to allow you to send accounts to an outsourced vendor to perform billing, follow–up, or collection activities on your behalf. Through ERM, you can manage and monitor vendors’ performance as they work through their designated patient accounts. Plus, virtually no extra training is required since ERM is an extended component of Patient Accounting.

Benefits

  • Improve receivable management for outsourced “early out” accounts
  • Monitor and manage the performance of your early out partners
  • Designate certain receivables for internal follow-up for appeals, audits, or special projects
  • Increase efficiency with automated secondary assignments to move accounts to other vendors or back to worklists for review

Business Analytics

QuadraMed Business Intelligence (QBI) is a turn-key enterprise reporting solution that unlocks the power of the rich content of Affinity’s Revenue Cycle solution. QBI can transform the way people communicate and use information to guide decision making. Through its easy-to-use portal interface and role-specific summary dashboards, QBI enables proactive management of the revenue cycle. This leads to operational improvements and increased profitability.

Benefits

  • Automated data extraction
  • Delivers a secure, web-based access to financial, strategic and operational data
  • Includes Denial Management analytics and Payer Scorecards
  • Provides users with a comprehensive cube-based business analytics engine and warehouse
  • Opens up Affinity data for new insights and analysis using tools already familiar to most users.