Healthcare reform is one of the biggest challenges the healthcare industry faces and will have significant impacts on revenue cycle processes and how you get paid. Inefficiencies in the Revenue Cycle result from some unavoidable complexities in billing due to existing rules and regulations but most often from ineffective business process management.
GE Healthcare’s Centricity Business is a proven, next-generation healthcare revenue cycle management solution that supports traditional and accountable care reimbursement models. With Centricity Business, your institution can thrive during this industry shift and drive greater profitability, efficiency, and enhanced quality of care.
Bridge the Gap
Working with nearly any clinical or third party system, Centricity Business seamlessly interoperates across boundaries through established data connectors and triggers.
Automate Best Practices
Software and experienced service teams can help achieve industry best practices across the revenue cycle to help automate workflows and lower cost.
Enterprise task manager is a low-touch solution that helps organizations work more effectively, spending time only on issues that need human attention.
Our integrated, end-to end revenue cycle management solution also includes Centricity EDI and analytics that help improve processes and manage proactively.
Comprehensive analytics help uncover hidden revenue opportunities from within claims denials, manage productivity and improve profitability.
AXIA is offered on a Cloud-based SaaS model which does not require any “on-prem” infrastructure and associated maintenance and support costs.
Revenue Cycle Services
The ideal Revenue Cycle is achieved when all of the distinct processes run like parts of a well-oiled machine with data flowing effortlessly between them. Aside from some processes such as coding where human interaction is inevitable, manual intervention should only be required on an exception basis. A Billing office presented with details of an encounter at the earliest possible timeframe and acts on them based on an exception worklist will result in the most efficient workflow.
While automation derived from technological innovation can take care of many repetitive tasks, human intervention is still necessary to correct inevitable errors, choose the most relevant medical codes, proactively follow-up on late payments or analyze reasons for denials. Consequently, the powerful Centricity Business Platform will be supplemented by Data-Core’s experienced taskforce who will service the worklists, ensuring that all necessary processes are performed in a timely manner with the desired level of accuracy.
For Payers participating in EDI, the eligibility verification is performed through GE’s Clearinghouse. In cases where this mode of verification is not possible, trained associates will verify eligibility by manually visiting the carrier website or calling.
Planned procedures requiring pre-authorization are flagged from the eligibility check and associates reach out to the payers to obtain the authorization prior to the visit.
Coding & Billing
Accurate coding of patient charts establishes the foundation of proper billing, improves rejection rates, helps prevent under/over-billing and minimizes the reimbursement lifecycle.
Scrubbing & Submission
Claims are scrubbed using a rules-based engine prior to submission. This step significantly improves the clean-claims rate and ensures quicker reimbursements.
Our robust Lockbox process is geared towards timely handling of mailed remittances on a daily basis. Payments are deposited to the designated bank via Image Cash Letter.
Payments from all sources are consolidated and analyzed to post correctly into the respective patient accounts and reconciled with total reimbursements.
Our expert follow-up team proactively pursues all unacknowledged, unpaid or partially paid claims that have crossed the set time period within Centricity Business.
Denied claims are addressed on a priority basis - our Denial Analysts perform a root-cause analysis to identify why the claim was denied and re-file or appeal the denial.
The goal of patient engagement is to have them working together with their healthcare Providers to improve their health and well-being. Studies have shown that patients want to be engaged in their healthcare decision-making process, and engaged patients tend to be healthier and have better outcomes.
Data-Core’s Patient Engagement Solution follows the patient’s journey from pre-care, treatment, and coordination of care, ending with patient satisfaction. The solution incorporates widespread use of Web and Mobile Technologies with added human touch, whenever deemed necessary.
The Patient Portal is the primary tool for communication between the Provider and the Patient. It allows patients to perform registration, schedule appointments,make payments, check medical records, and receive targeted educational materials.
An estimate of patient liability is calculated during the pre-admission process and presented to the patient.
Patient statements are generated and updated on the portal. Budget payment plans may also be offered depending on financial need. Follow-up for any pending balance is done through the mobile-app or by making phone calls.
Save time and improve your waiting room experience by automating the entire check-in process. Insurance info, medical history, privacy or other notifications are presented, updated and signed-off on mobile devices.
Our solution helps patients to better prepare for their upcoming visit. The advice includes directions to the facility, eating/ fasting instructions, and anything else deemed necessary.
Spare the loved ones undue anxiousness by keeping them informed at all times. Designated family members/ caregivers receive necessary updates from the patient’s healthcare team.
The discharge advice, post-care treatment plan, educational materials and any required follow-up visits are communicated to the patient. Care-coordination needs patients are tracked and routed as necessary.
Brief surveys are sent to patients and/or designated family members/ care givers to record their experience during the entire care process.
Non-emergent medical questions from patients are reviewed by the patient care team and responded to in an appropriate manner.
Access to on-demand real-time data is a concern for most healthcare providers. In order to address increasing regulatory pressures, shrinking margins and demands for clinical outcomes, a large amount of time is spent trying to obtain and compile information.
Our Analytics solution turns complex data into meaningful, easy to understand information. It allows you to visualize the financial health of your business with real-time dashboards and customizable reports, so you can quickly identify areas for improvement and make more informed decisions. Dashboard drill-downs provide immediate insights, a robust reporting library and ad hoc reporting engine support ongoing operations and compliance. You gain complete visibility on key areas of your organization such as:
Predictive and Cognitive Analytics