ARTIVA HCx SOLUTION. from Ontario Systems

Transcription

1 ARTIVA HCx SOLUTION from Ontario Systems

2 THE ARTIVA HCx SOLUTION In a shifting healthcare market challenged by the rise of high-deductible health plans, reimbursement reductions and regulatory reform, providers across the country are struggling to navigate their organizations to positive financial health. These challenges are forcing many to look at process redesigns, affiliations or acquisitions to boost their financial performance. While these efforts can lead to better financial margins, they also present a new challenge in providing the patient with a single experience as they engage the provider s new network across multiple legacy systems. Factor in the importance of patient satisfaction with new reimbursement models and this challenge becomes even more pronounced. To discover the productivity enhancements they need, healthcare financial leaders need to alter their processes for more cost-effective operations, and combine their data into one integrated system that provides a single experience for the patient. No longer can providers tolerate the inefficiencies introduced by multiple solutions from multiple vendors: They need a single solution with the best embedded data services and tools on the market, managed by one partner. By blending technology, data services and strategy support, you can increase productivity and reduce the cost to collect. The Ontario Systems Artiva HCx solution is your intelligent guide to accelerated revenue recovery from payers and patients. It helps you make better data-driven decisions, improve patient experiences, and boost agent productivity. Key components of the solution reviewed in the brochure include: Insurance Receivables Management Detailed work processes incorporate automated claims status monitoring, reduced hold times when calling the payer and look-ahead processing with an integrated contact management system when contacting payers. Combine this with exception-based workflows and this maximizes productivity, reducing your cost to collect. Denials Management Aggregation of key denial CARC codes into subcategories expedites and automates follow-up and appeals tracking. Integrated contact management system with reduced hold times for calling payers dramatically increases productivity. Self-Pay Management Accounts are prioritized with detailed segmentation, and missing insurance along with financial assistance, is identified to determine a custom contact strategy. An integrated contact management platform ensures quality assurance as your patients are contacted. Contact Management Cloud-based Contact Savvy contact management solutions from Ontario Systems come included and seamlessly integrated with the ArtivaHCx solution, providing both manual dialing and fully-automated inbound/outbound call routing, IVR and messaging capabilities. This fully integrated technology solution helps providers improve productivity, reduce cost to collect and provide one single patient experience.

3 INSURANCE FOLLOW-UP & DENIALS MANAGEMENT The Artiva HCx solution enables providers to aggregate data from multiple systems for streamlined insurance follow-up and denials management with insurance hold time reductions when calling payers, insurance analytics, intelligent exception-based workflows, automated claim statusing and integrated embedded data enhancement through a single platform. The process ensures only the highest yield accounts are worked, improving productivity, reducing the cost to collect and providing one singular map to success for the business office. The Artiva HCx solution leverages a proven platform, creating standard workflow processes that focus on intelligent exception-based processing. Detailed business rules data from multiple sources like claim statusing technology, and the EDI X and 277 are incorporated into the workflow, driving accounts to the right team at the right time. Multiple and duplicate denial CARC codes are grouped into strategic key subcategories to reduce administrative time spent working them. Key analytics trending and dashboard reporting are used to pinpoint key areas of improvement not only by payer and denial category, but by specifics like balance range and other key data variables on the accounts. Innovative predictive technology reduces hold times dramatically when calling payers. With all of these functions combined in a single place, agents can make smarter, faster, data-driven decisions, which dramatically improves productivity and efficiency. The Artiva HCx solution provides these key benefits: Increase productivity when calling payers Gain dramatic productivity improvements by utilizing our solution that cuts hold times when calling payers improving productivity by 25%. Handle processes across departments Experience streamlined efficiencies by integrating operations throughout your health system. Standardize workflows to enhance productivity Gain a single user experience for more efficient account rep onboarding and more streamlined processes, leading to distinct productivity improvement, cost reductions and increased revenue. Exception-Based processes to work more inventory With detailed business rules, insurance analytics and automated data enhancement services, only the accounts needing follow-up are driven to representatives for resolution, allowing providers to effectively manage their whole inventory instead of a smaller percentage today. Strong ROI with Strategy Analyst A long term strategic partner is assigned to help your system and process achieve a strong ROI. Reduce administrative burden and cost Eliminate multi-vendor management with single pricing, handled by Ontario Systems. By leveraging all our clients bargaining power, we negotiate rates at a much lower fee schedule. Key Analytics Reporting to enhance performance Using a single platform to track all data elements yields revenue cycle dashboards with key KPI metrics to measure your insurance follow-up and denial processes across the system, providing key trending data for a single view across your revenue cycle performance.

4 SELF-PAY RECEIVABLES With the average deductible increasing 255% since 2006 and projected to continue its growth trajectory, the task of collecting self-pay dollars from patients is a daunting one. The task becomes even more pronounced when factoring in the importance of patient satisfaction tied to new reimbursement models. Working every account is economically impossible, so providers must find ways to manage productivity by using segmentation to determine which accounts to work and which ones to look at for financial assistance and/or teamsourcing to a partner. To ensure you are achieving a positive patient experience every time, a fully-integrated call solution that enables call recording and provides strong QA is a must. In short, healthcare financial leaders must maximize productivity, minimize cost to collect and increase recoveries to reduce bad debt write-offs and raise patient satisfaction. The Artiva HCx solution empowers you to meet these challenges with a fully-integrated engagement suite that enables patients to interact with you on their terms and at their convenience. Furthermore, the system helps you segment and prioritize accounts; formulate appropriate contact strategy; reach out to patients in compliance with federal and industry regulations; record calls and tie them directly to accounts for future reference; and accept payment according to standards like the PCI-DSS, and legislation like the Electronic Funds Transfer Act (EFTA). Key components of the solution include: Patient Visits/Accounts & History Provide account reps with detailed information about the number and nature of services rendered, on a single web-based screen for maximum efficiency. Scoring Prioritize accounts with segmentation, informing appropriate overall contact strategy for maximum self-pay recovery. Insurance Verification Automatically accounts for missing insurance information. Charity Automatically review financial assistnace options for patients, and extend opportunities to the right accounts, at the right time. Fully-Integrated Contact Management Execute outreach campaigns according to strategies matching account segmentation, CFPB standards, and legislation including HIPAA, TCPA, UDAAP, and FDCPA. Reporting & Analytics Performance reporting by prioritization tier, analysis by facility and region, snapshot analysis to help spot trends, and breakdowns by financial class and patient type. The Artiva HCx solution features an unmatched degree of integration as a fully-fused patient engagement suite. No other platform available provides a holistic self-pay experience, managing financial information from the moment a patient checks in to the moment their balance reaches zero. By leveraging proven technology that aggregates multiple systems and affiliates into one strategic network, the Artiva HCx solution enables unmatched efficiency in self-pay receivables to increase recoveries and reduce the cost to collect.

5 CONTACT MANAGEMENT Expanding self-pay volumes and complexities surrounding insurance and denials follow-up have created a bigger burden on providers and their teamsource partners. The need for a holistic telephony solution that manages compliance and guides agents is critical to improving productivity and providing a positive experience to the patient. When you consider contact management in your receivables strategy, enhancing patient service and reducing solution complexity should be your two biggest priorities. Reduce hours spent wrangling your tech infrastructure, save your representatives time, talk to more patients, pay less for telecom, and help ensure airtight compliance and strong QA Those are your challenges. What s the best way to meet them? Cloud-based Contact Savvy contact management solutions from Ontario Systems come included and seamlessly integrated with the Artiva HCx solution, providing both manual dialing compliant with the TCPA and fully-automated inbound/outbound call routing, IVR and messaging capabilities. Hosted at our facilities, saving you the cost and effort of upgrading and managing your own hardware, Contact Savvy is operated using the same user interface your account representatives use today. It s perfectly integrated with Artiva HCx technology, providing key productivity metrics to help you manage staff efficiently and effectively. The Contact Savvy solutions enable you to: Manage inbound customer service and patient follow-up calls Deliver outbound collection dialing campaigns Present the patient with interactive, self-service IVR options Scale dialing capacity to meet demand Record calls attached directly to the account for review by any representative or manager Report performance data to management and staff members for more easily-determined adjustment to your operations QA tools to help ensure the patient has a consistent experience every time they reach an agent The unique benefits of a cloud-based dialer/ivr/messaging solution fully-integrated with your application platform provide tremendous value when managing your receivables management process. The benefits include lower cost of ownership, no per-seat license restrictions, higher contact rates, more inbound connects, and reduced operational complexity all in service of better patient satisfaction and increased cash recoveries.

6 WHY CHOOSE THE ARTIVA HCX SOLUTION? The Artiva HCx solution drives teams to make faster, more informed decisions. Our software aggregates the right data, so teams can take effective action. And the intuitive user interface guides healthcare revenue teams through the day-to-day business of revenue recovery, avoiding the typical roadblocks in the revenue cycle. Intelligent decision-making tools empower healthcare revenue teams to do more with less. The integrated patient engagement suite provides real-time updates to key patient facing tools like the IVR, inbound call centers and patient portals. All of these products and services come together to give the patient a complete picture of their payer and patient liabilities, helping to achieve a true single patient experience. Even if you outsource collection activity, segmentation can help identify those patients who will pay, leaving you with the option to forward more difficult accounts to your partners. You decide which accounts to work in-house, and for how long, before placing them with outside agencies. That strategy helps provide a positive patient experience for your best customers and more dollars to fuel your mission. Gain that advantage today, and reap the benefits of a highlyorganized, well-known self-pay inventory portfolio tomorrow. The Artiva HCx solution provides these key benefits: Increase staff productivity Work accounts you do not get to today Increase pace and likelihood of payer reimbursement Raise patient cash collected Reduce cost to collect Reduce bad debt write offs Improve patient satisfaction Reduce administrative cost to managing multiple vendors Contact Ontario Systems today to learn more.