Join revenue cycle management expert Elizabeth Woodcock & James Muir to dissect the eight strategies for surviving and thriving in today’s turbulent reimbursement environment. This webinar will empower you with solutions to make your practice a top performer. In addition, attendees of this live webinar can quality for CEU credits.*
After this session, you’ll be able to:
Evaluate payer contracting opportunities and pitfalls
Determine contract management procedures to ensure appropriate payment
Implement effective methods of setting patient’s expectations for payment – before the visit
Apply time-of-service collections techniques
Develop denial prevention and management procedures
Assess technologies to support efficient revenue cycle management
Identify staffing needs for successful revenue cycle management
Differentiate the elements of reporting key performance indicators for revenue cycle management
Eight strategies to get paid - Revenue Cycle Management
1. Welcome to the Webinar
8 Strategies to Get Paid Every Dollar You
Deserve
We’ll begin in a few moments.
2. Before we get started there are a few
housekeeping items
• This webinar is being recorded
• For an uninterrupted presentation, lines will be
muted for the duration of the webinar
• We will address questions at the end of the
presentation via the chat function
• Feel free to submit questions via chat throughout
the presentation
• Details on getting your CEU credits will be covered
at the end of the presentation
• Handouts from today’s presentation will be emailed
to you within 24 hours
3. MBA, The Wharton School of Business, University of Pennsylvania
BA, Duke University
Fellow, American College of Medical Practice Executives
Certified Professional Coder
Author, 12 textbooks and more than 500 Articles
Founder and Principal, Woodcock & Associates
Former Consultant, Medical Group Management Association; Group Practice Services Administrator, University of Virginia Health Services Foundation; Senior Associate, The Advisory Board Company
25+ Years in Revenue Cycle Management & Billing Service Administration
BA, Brigham Young University
Author, 2 books, hundreds of articles including articles for the MGMA Connexion and Advance For Health Information Executives
Educator for many organizations including various MGMA chapters and Metro managers groups.
Certifications from IBM, 3Com, Miller-Heiman, Franklin Covey and JES.
Longstanding active participant with MGMA & HFMA
3
Elizabeth W. Woodcock, MBA, FACMPE, CPC Speaker, Author, Trainer www.elizabethwoodcock.com
James M Muir VP Revenue Cycle Management NextGen Healthcare Speaker, Author, Educator www.linkedin.com/in/puremuir/
26. What Exactly Does RCM Services Offer?
NextGen RCM Services helps
clients address these challenges &
others via:
• Account Management &
Oversight
• A Tailored Solution
• Access to the Full Suite of
NextGen® solutions
27. How NextGen Healthcare Helps you Address Top
Challenges
Self-pay Collections
Rising operating cost
Preparing for new
reimbursement models
Optimizing an existing
EHR
Self-Pay Collections
Get the support of RCM experts who collect more efficiently & at a
lower cost — optimizing your workflow, back office functions, and
bottom-line, while eliminating strain on your time, money & internal
resources.
We deliver the staff training, best practices, process enhancements,
technology & professional resources to connect with a higher volume
of patients more efficiently and get every dollar you have earned.
Our unified clinical & financial management solutions are built to
manage & anticipate change with functionality for ACOs &
risk-based models.
Our HIT experts configure your systems to take full advantage of
technology to drive revenue to its fullest potential & improve
your staff productivity.
28. End to End Revenue Cycle Management (Typical Deployment)
SYSTEM ADMINISTRATION, PM DATABASE CONFIGURATION, WORKLOG MANAGER, TRAINING, CLIENT CUSTOMER SERVICE
CHARGE ENTRY
INBOUND SERVICE AUTHORIZATION
SCHEDULING
CHECK-IN REGISTRATION
POS COLLECTIONS
ASSIST WITH CHARGE CAPTURE
ACCOUNT
MANAGEMENT/ OVERSIGHT
PRE-SERVICE
POINT OF SERVICE
POST-SERVICE
CLAIM RECONCILIATION
BILLING & COLLECTIONS
REFERRAL
MANAGEMENT
INSURANCE ELIGIBILITY VERIFICATION
ANALYSIS
PATIENT STATEMENTS & CORRESPONDENCE
CODING SERVICES
CLAIM SCRUBBING
CLEARINGHOUSE EDITS
CLAIM SUBMISSION EDI & PAPER
PAYMENT
POSTING ERA & PAPER
CLAIM RESOLUTION
PATIENT CUSTOMER SERVICE
A/R MANAGEMENT
INSURANCE FOLLOW-UP
DENIAL MANAGEMENT & RESOLUTION
APPEALS MANAGEMENT
REFUNDS & OVERPAYMENTS
A/R FOLLOW-UP DELINQUENT ACCOUNTS
CONTRACT MANAGEMENT
FINANCIAL RECONCILIATION TO BALANCE MONTH/DAY
PERFORMANCE REPORTING
DASHBOARDS
DATA WAREHOUSE REPORTING
INSIGHT REPORTING
TRANSITION TO EXTERNAL COLLECTIONS
CODING AUDITS
CREDENTIALING/
PROVIDER ENROLLMENT
= RCM Services
= Client
= 3rd Party Vendor
CARE
MANAGEMENT
CLINICAL DATA MANAGEMENT
VIRTUAL CLINICAL DOCUMENTATION
ENHANCED CARE DELIVERY
CARE COORDINATION
29. End to End Revenue Cycle Management (Tailored Deployment)
SYSTEM ADMINISTRATION, PM DATABASE CONFIGURATION, WORKLOG MANAGER, TRAINING, CLIENT CUSTOMER SERVICE
CHARGE
ENTRY
INBOUND SERVICE AUTHORIZATION
SCHEDULING
CHECK-IN REGISTRATION
POS COLLECTIONS
ASSIST WITH CHARGE CAPTURE
ACCOUNT MANAGEMENT/ OVERSIGHT
PRE-SERVICE
POINT OF SERVICE
POST-SERVICE
CLAIM RECONCILIATION
BILLING & COLLECTIONS
REFERRAL
MANAGEMENT
INSURANCE ELIGIBILITY
VERIFICATION
ANALYSIS
PATIENT STATEMENTS
& CORRESPONDENCE
CODING SERVICES
CLAIM SCRUBBING
CLEARINGHOUSE EDITS
CLAIM SUBMISSION EDI & PAPER
PAYMENT
POSTING ERA & PAPER
CLAIM RESOLUTION
PATIENT CUSTOMER SERVICE
A/R MANAGEMENT
INSURANCE
FOLLOW-UP
DENIAL MANAGEMENT & RESOLUTION
APPEALS MANAGEMENT
REFUNDS & OVERPAYMENTS
A/R FOLLOW-UP DELINQUENT ACCOUNTS
CONTRACT MANAGEMENT
FINANCIAL RECONCILIATION TO BALANCE MONTH/DAY
PERFORMANCE REPORTING
DASHBOARDS
DATA WAREHOUSE REPORTING
INSIGHT REPORTING
TRANSITION TO EXTERNAL COLLECTIONS
CODING AUDITS
CREDENTIALING/ PROVIDER ENROLLMENT
= RCM Services
= Client
= 3rd Party Vendor
CARE
MANAGEMENT
CLINICAL DATA MANAGEMENT
VIRTUAL CLINICAL DOCUMENTATION
ENHANCED CARE DELIVERY
CARE
COORDINATION
30. Your NextGen RCM Account Manager:
• Is your Client Liaison for all issues & resolutions
• Is responsible for monitoring the overall
performance of your account (oversight)
• Will explain & help you understand all KPIs &
Reports discussed in your regularly scheduled
meetings.
• Has access to specialist teams & resources
within NextGen to evaluate & resolve any
specific issues.
31. Account Manager Functions Can Be Broken
Down Into Four Areas
1. Oversight
– Financial Performance
– Operations
– Best Practices
2. Guidance
– Establishing Practice Goals
– Addressing Outstanding & New Items/Issues
– Addressing Items Impacting Revenue
3. Education
– Call Center Statistics
– Training
– Policy & Procedures
– Payer Notifications
4. Ongoing Support
– Systems & Software
– Integration & Technical
– Changes in practice environment
32. Getting Your Complimentary RCM Assessment
Attendees of this Webex are
eligible for a free consultation
with their NextGen Healthcare
Director of Revenue Cycle
Management to learn how they
can qualify for a free RCM
assessment valued at $3,500.
Email Jill Ryan to set up your
appointment:
jryan@nextgen.com
33. Panelists Q&A
Elizabeth W. Woodcock,
MBA, FACMPE, CPC
Speaker, Author, Trainer
www.elizabethwoodcock.com
James M Muir
VP Revenue Cycle Management
Speaker, Author, Educator
www.linkedin.com/in/puremuir/
34. Getting Your AAPC CEU Credit (1.0 CEUs)
Attendees of this Webex are eligible for AAPC CEU Credits!*
Email Jill Ryan to receive the documentation for your AAPC
CEU Credits:
jryan@nextgen.com
* This program has the prior approval of AAPC for 1.0 CEUs of continuing education hours. Granting of prior
approval in no way constitutes endorsement by AAPC of the program content or the program sponsor. AAPC
accepts credit hours for the live webcast of this presentation. Recorded sessions are not eligible for credit.
35. Getting your ACMPE Credit Hours (1.0 CEU)
Here are the instructions for viewing your transcript on line and entering your
ACMPE credit hours:
• Go to http://www.mgma.com/myTranscript/
• Log in with your membership ID and password.
• Follow the instructions and the CEUs will appear up on your Transcript in 24-
48 hours*
• For the Credit hour calculation add the total number of clock hours for the
duration of the program.
* Note: ACMPE accepts credit hours for the live webcast of this presentation. Recorded sessions are not
eligible for credit.
36. Thank you
Contact information for any additional questions:
James Muir
Vice President RCM
JMuir@rcmguy.com
www.linkedin.com/in/puremuir/
Elizabeth W. Woodcock, MBA,
FACMPE, CPC
Speaker, Author, Trainer
elizabeth@elizabethwoodcock.com