Revenue Cycle Management

Strategized for Success

Sensibill’s strategy for success is focused on technological tools and functions for it’s outsourced revenue cycle management solutions. We have implemented a multitude of solutions for an overall total impact to the bottom line profitability.

Set up According to functions:

-Customer Service & Correspondence

Sensibill understands the billing procedures and policies of each client. Our personnel identify themselves as the client's billing department and are trained in the client's billing procedures. Calls from patients are sequentially routed to the next available representative resulting in an average patient wait time of less than 3 minutes.

-Charge/Payment Posting

The Sensibill Entry & Client Deposits team enters charges daily from a variety of transfer methods. Charges are batched and carefully balanced prior by the client daily closeout.

Examples of transfer methods used are:

• System to System file transfer
• Shared Drives
• Hard Copy
• Directly to Client

For example, in the case of pathology, every accession number is entered, reviewed, and cross referenced to a pathology report. Client fee schedules and payer negotiated fees are maintained by our system allowing our staff to know immediately when a claim has been paid incorrectly.

-Accounts Receivable & Collections (payer specific)

Our Accounts Receivable staff is assigned by payer and patient responsibility and are experts in payer policies and personnel. Routine follow-up on unpaid claims begins with payers at 45 days. We aggressively follow-up on every claim paid incorrectly. Payer aging of accounts is reviewed monthly by management and the patient aging of accounts is also rigorously monitored and collections are pursued according to a policy established with the client at the time of contracting.

-Ancillary Staff

Sensibill also has, on staff and available, ancillary staff to service the needs of our clients. We have specialists in software programming, coding, physician fee schedules and managed care contracting. Our ancillary staff specialize in leveraged solutions to meet specialized client requirements.

Additional Services include:

• Refund administration
• Procedure and Diagnosis coding and compliance
• Inbound and Outbound Electronic Data Interchange
• Electronic Remittance Advice (ERA) with underpayment analysis
• Contact and Denial Management
• Standardized and Custom management reporting with online access to data and reports
• Payer Reimbursement Tracking through Lag Reporting
• Capitation
• Risk Management
• Billing system data reconciliation
• SP Model
• Document Image Retrieval

Sensibill's use of Allscript’s Professional PM software along with our highly professional staff allow us to offer many services to our clients all with the focus of sending dollars straight to their bottom line. Allscript’s responsiveness to our requests has allowed us to tailor our business model to that of our clients’ to enhance the workflow and reduce their downtime. With their system in place, we can offer both their own built-in reports as well as our customized reports in order to really drill down into the revenue cycle and to find the best places to focus on to increase revenue. Some of the financial benefits of our system are:

• Improve day-to-day collections and cash flow
• Manage and reduce outstanding AR
• Reduce billing errors delaying cash flow
• Increase collections at time of visit
• Access information to improve efficiency and increase revenue
• Provides valuable insight into the practice

Some of the many tools we offer our clients for their own use include:

A Digital Dashboard – a single secure screen to allow quick access to information including appointments, a summary of A/R, charges, receipts, and claims status.

Rules-based Scheduling – a simple, flexible environment where access to multiple documents and functions can be set to

• Electronic funds transfer
• Monitor insurance and third party payers
• Adjust pricing and processing procedures with ease
• Reduce late, no-show, missed and cancelled appointments
• Benchmarking monthly revenue
• Compliance with Federal and State Regulations (i.e. Medicare, Medicaid and Worker’s Compensation)
• Electronic payment processing
• Provides valuable insight into the practice