Improve Revenue Cycle Management Efficiency and Increase Net Patient Revenue
Hospitals, health systems, academic medical centers and their physician practices are under pressure to improve the quality of care while simultaneously facing declining reimbursement, increased risk and margin pressure. For many healthcare organizations, maximizing revenue cycle efficiency and improving the areas of medical billing, coding and accounts receivable management are paramount to achieving the goals defined by healthcare reform.
Partner with a Revenue Cycle Expert So You Can Focus on Delivering Quality Care
Identifying incremental reimbursement opportunities can deliver an immediate return without a significant amount of time or cost. This first step gets your revenue cycle in good working order as you go down the path of value-based care.
McKesson helps hospitals improve profitability with revenue cycle management services designed to help them maintain focus on patient care. As an extension of your team, we have the resources and depth of experience you need to help strengthen the financial health and profitability of your whole organization.
If your healthcare organization is struggling to maintain its revenue cycle operations, McKesson’s end-to-end revenue cycle management and medical billing services can provide as much – or as little – help as you need. Our domain expertise in both physician and hospital billing and claims management, combined with end-to-end revenue cycle management services, can help your organization reduce operating costs and accelerate cash flow.
Essential Revenue Cycle and AR Management Services
Increasingly, chief financial officers are partnering with experts to administer core revenue cycle and accounts receivable management processes to become more operationally efficient and improve financial performance. As health systems struggle to take on professional-fee revenue cycle responsibilities for newly employed practices, we can provide support to help manage coding, billing and even technology platforms for both hospital and physician revenue cycle management.
- Medical Coding and Healthcare Regulatory Compliance: From full outsourcing to episodic project work, our coding services address both sides of coding by identifying missed revenue opportunities as well as potential compliance risks due to inaccurate coding. In addition, we can help your team with clinical documentation improvement, audit management, and staff training and education. A healthcare compliance plan assessment, development and monitoring program can help your organization mitigate risk and focus on compliance improvement.
- Claim Management: Our team scrubs procedural and diagnosis codes against Correct Coding Initiative and payer-specific edits. We provide charge capture audits to confirm that charges and receipts are not missed by reconciling patient charges in the hospital, office, clinics, surgery suites and more. We also review charge data prior to billing to help you capture all charges and payments.
- Billing and Payment Management: From insurance billing and patient statements, to payment posting and validation, McKesson can help manage the critical processes that directly affect one of your most important KPIs: AR Days.
- Extended Business Office Services: Our team of experts can augment your staff with both insurance and patient accounts receivable follow-up services. For insurance accounts receivable follow-up, we can contact payers to determine claim status and root causes of delinquent claims, and then provide the information needed to resubmit claims or initiate appeals. Our patient balance follow-up for self-pay payment collection is handled efficiently and respectfully. We use a predictive dialer to place follow-up calls to patients to request payments and can help establish customized payment plans according to your policies and procedures.
- Early-Out / Collections Management: Your hospital can decrease bad debt and increase revenue by giving us the hard-to-collect claims. Depending on your needs, we can focus on outstanding claims, including out-of-pocket amounts and across payer types, by age and by balance.
- Managed Care Services: Our contract experts can review your third-party payer contracts, analyze future contracts and help you prepare for your payer contract negotiations. We can also track managed care contractual agreements including renewal dates and contract terms to help you maximize the profitability of current contracts.
AR Management Services that Address Growing Healthcare Trends
Consider partnering with an expert for AR management services that have become increasingly important given these growing trends in healthcare: increasing complexity of payer contracts, mergers and acquisitions that affect system platform strategy, and the rise in self-pay accounts due to high deductible health plans.
- Medical Denials Management and Underpayment Recovery: From full outsourcing of your denials resolution procedures to performing focused audits, our denials management team can offer as little or as much help as you need to maintain control of your financial performance.
- AR System Conversion: We work through your existing accounts receivable balances while your staff focuses on the new system’s implementation and training. Our comprehensive support will help you recover balances both prior to and after system conversion, capturing revenue that is commonly lost during times of significant change.
- Self-Pay Collections: We’ve established the right combination of processes, technology and patient advocacy to help optimize collections and shorten collection cycles on patient balances. Acting as your extended business office, we help you reduce self-pay receivables, increase cash flow, reduce bad debt and optimize financial performance.
- End-to-End Revenue Cycle Management Services: Healthcare revenue cycle leaders are increasingly considering outsourcing their hospital and physician revenue cycle management operations in light of growing pressures to preserve financial performance, keep up with ongoing regulatory changes, reduce revenue cycle costs associated with getting paid and shift their focus to improving the delivery of care. McKesson can provide health systems with end-to-end revenue cycle management services and expertise as a strategy to help health systems improve revenue cycle management processes, become more efficient and positively affect their organization's financial health.
Revenue Cycle Insight and Analytics
As an extension of your business office staff, we help you accelerate cash collections through our best practice processes, automated tools and insight into your revenue cycle.
- Monthly Reporting: We provide you with detailed monthly reporting of net revenue calculations and cash flow projections based on payer mix and monthly trending.
- On Demand Analytics: The McKesson Practice Focus™ solution gives you on-demand and on-the-go access to your organization’s detailed medical billing and accounts receivable data, providing powerful insights into your revenue cycle with high-level dashboards, standard report templates, email report delivery and easy point-and-click navigation.
- Account View and Collaboration: Improve collaboration between your staff and ours to resolve account issues. Your revenue cycle and clinical teams can view patient account records to research patient inquiries and view billed claim history, facilitate requests for additional information, collaborate on recovering denials, and track and post time of service patient and other transactions entered by practice staff.