Your Revenue Cycle Never Stops, and Neither Do We

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1 NTT DATA welcomed Dell Services into the family in Together, we offer one of the industry s most comprehensive services portfolios designed to modernize business and technology to deliver the outcomes that matter most to our clients. Your Revenue Cycle Never Stops, and Neither Do We Revenue Cycle Management Services by NTT DATA Improve clinical and financial outcomes with leading automation technology and a certified global workforce of experts Over the last few years, the healthcare landscape in the Gulf Cooperation Council (GCC) has changed tremendously with the advent of new technology, patients being part of their healthcare decisions and changing economic conditions. But most GCC countries have a very diverse population with varying nationalities, educational backgrounds and cultural beliefs, which poses challenges in providing healthcare. Additionally, in 2014, the United Arab Emirates (UAE) implemented a healthcare reform law mandating health insurance for all Dubai and Abu Dhabi residents. It is only a matter of time before this law is introduced on a federal level to alleviate some of the UAE s healthcare economic risks and transfer ownership of a healthy lifestyle back to the ever-growing populace. As a result of this law, several systems, processes and procedures on the provider side need to change, such as registration, billing, coding, change and critical IT systems. And healthcare organizations are expecting increased financial pressure as the reimbursement model changes and the consumer, along with health plans, shoulder the healthcare costs. The key to managing this complex provider revenue cycle is to control cash flow and patient care while reducing overhead. And that s where NTT DATA can help. As a trusted revenue cycle provider to hundreds of health systems and organizations around the world, NTT DATA understands that the revenue cycle never takes a break. With a talented team of experts, an understanding of processes, in-depth knowledge of the latest healthcare technology and a global network of service centers, Revenue Cycle Management Services by NTT DATA never miss a beat. From a full-scale implementation of the revenue cycle process, to a short-term customized project addressing one part of the revenue cycle, or a cost-reduction strategy, NTT DATA offers solutions to achieve the results you need. Utilize breakthrough solutions that increase cash flow to improve your healthcare business.

2 Revenue cycle challenges in the GCC As the healthcare industry in the GCC transforms, it faces several challenges, including: The need to establish processes: Healthcare providers are realizing the need to establish revenue cycle processes to keep administrative costs down, strengthen cash flow, streamline medical records, and deploy processes to ensure accurate claims and policy administration. The lack of skilled and talented healthcare professionals: Healthcare organizations struggle to find the right resources who are trained to handle revenue cycle functions. The lack of skilled and trained healthcare professionals adversely affects the overall hospital performance. The high cost of billing and collections: With healthcare reform in place in parts of the GCC, there is a growth in the number of self-pay accounts with an increased possibility of billing errors, including uncollected revenue or unexpected care charges that could shock patients with bills they are unable to pay. Errors in billing and collections can cause providers millions of dollars unless there is a better understanding about patient responsibility and a process in place that could help streamline the transactions. Delays in performing necessary functions: The increased demand on staff and additional administrative work have led to delays in payment to providers and, most importantly for patients, delays in the approval of claims and medical procedures. Long waiting periods for claims adjudication: Waiting for claims to be processed and adjudicated can delay care managers from receiving crucial information by months. A patient s health can deteriorate dramatically during this period, which can lead to costly events such as visits to the emergency room, hospital admissions and readmissions. Our areas of expertise By working with NTT DATA, you get access to an experienced team of highly skilled revenue cycle specialists. Our network of service centers takes advantage of scale, automation and proven processes, which means that your revenue cycle operations gain performance efficiencies to maximize cash flow. And with our team of resources located across the world, you can get work done around the clock, so your revenue cycle operations never sleep. The result is a high-yield, efficiently run revenue cycle from end to end. Patient access Billing Receivables Appointment Scheduling Eligibility verification and registration Coding Charge capture Provider enrollment Preadjudication Claims submission Rejection and denial Account resolution Payment posting Credit balance and refunds Bad debt and collections Patient appointment and scheduling Financial counselling Account creation Pre-registration Eligibility verification Benefits Pre-certification/prior authorization Patient registration New Existing E-demo Coding Prospective coding Physician coding Facility outpatient Facility inpatient Hierarchical Condition Category (HCC) coding Physician Quality Reporting System (PQRS) coding Coding audit Codes audit Documentation audit Physician education or clinical documentation improvement (CDI) Charge entry Manual charge EMR charge Copay Claim submission Work edit System edits Clearing house rejects Insurance rejects Updating fee schedule Provider enrollment and credentialing Payment posting Electronic remittance advice (ERA)/explanation of benefits (EOB) download lockbox and insurance websites Payment batch prep Insurance and patient payments manual Insurance payments ERA/EFT Denial posting Correspondence Indexing Day/month close AR follow-up Claim status Unpaid follow-up Denial Denial analysis, appeals, coding denial, underpayment review Patient refunds Insurance refunds Bad debt/pre-collection process Collection agency payments Allowable monitoring Conveyance and small balance adjustment Unapplied/suspense Patient statement Return mail and bad address correction Patient inquiry process Patient follow-up Figure 1: End-to-end revenue cycle 2

3 Scheduling Registration Eligibility verification Charge entry Claim submission Insurance Follow-up Management and operational reporting Check writing / refund processing Process Revenue cycle standards and guidelines Education and training Compliance Mature governance model Revenue system Technology People Distributed business 5,000+ revenue cycle experts process system Offshore arbitrage Testing Coding expertise Security Data analytics Audit Web reporting Denial Lockbox processing Bad debt processing Self-pay collections identification Self-pay statement generation Payment posting Figure 2: Data flow for revenue cycle projects Revenue cycle outsourcing/ implementation Increase your net cash with improvements that can add millions of dollars annually to your bottom line. By establishing and executing the best processes and practices, we help deliver measurable reductions in the costs associated with your revenue cycle operations. Patient access transformation Patient access is usually the first point of contact a patient has with a hospital and with the revenue cycle. It s also the most important, and not just for the patient. Data collected during this process can dramatically impact accuracy and payment turnaround in the latter stages of the revenue cycle. Admission and registration data that is full of integrity and accuracy issues can dramatically increase rework with denied claims. This can adversely affect cash flow, and create inefficiencies that lower patient satisfaction through a perception of poor customer service. NTT DATA can help transform your patient access functions from simply admitting and registering patients and verifying insurance, to achieving high-value customer service and capturing all relevant patient data. Revenue cycle projects Having collected billions of dollars for our clients, NTT DATA is an industry pioneer in providing short-term, onsite cash recovery projects. Whether your challenges are Day 1, Day 150, accounts receivable (AR), a specific financial class or a system conversion, you can experience a rapid increase in cash with our customized solutions: 3 Onsite cash recovery projects are intensive programs that increase cash flow in the shortest possible time. We work on site with your team to resolve aged AR to quickly generate cash. Computer conversion solutions have a proven track record of successfully managing receivables during a system migration or upgrade. We work on site to maintain a steady cash flow during the conversion project, which also provides your team with a fresh start in working receivables in the new system. Staffing solutions provide assistance where you have revenue cycle gaps. Our revenue cycle professionals possess deep industry knowledge and will be on site as long as you need them to provide and oversight in any area of your revenue cycle. Health information (HIM) In addition to helping augment your revenue cycle processes, NTT DATA also specializes in enhancing HIM workflow and improving clinical data integrity. Our team of experienced and credentialed former clinicians, hospital administrators and HIM specialists have a deep understanding of healthcare, compliance and regulatory issues. They can address every aspect of your operations and planning activities, including: Coding/remote coding HIM sourcing Charge description master review, updates and revision Master patient index cleanup Charge capture audits to find lost revenue Interim Operational assessment and improvement Strategic electronic medical record plans Discharged not final billed reduction solutions Transcription assessment and Recovery Audit Contractor/Medicare Integrity Contractor preparation Case mix analysis Claims denial review Resolution of National Correct Coding Initiative (NCCI) edits and outpatient medical necessity edits Extended business office programs Hard-to-collect receivables from self-pay and third-party accounts create a weak link in your revenue cycle. Our extended business office solutions which have driven financial results for hundreds of healthcare providers across the world can help you strengthen that link. By providing deeply experienced onsite and offsite resources to your business office, we help generate cash from difficult-to-collect accounts to achieve the results you expect. Using shortterm and long-term solutions, our team focuses on all areas of your billing and collections cycle. The result is extra cash for your facility. For added peace of mind, our staff and network of service centers are securely connected to your facility, ensuring your patient and billing data remains protected.

4 Value beyond the Service Levels and Costs Financial benefits 30-50% cost savings Revenue acceleration through improved turnaround time Analytics to improve process outcomes Financial benefits Best-practice delivery environment Best-in-class certifications ISO 9001, ISO SSAE 16 Certified Quality Improvement Professional (CQIP) and Six Sigma Fully automated delivery environment Stronger governance through automated workflow, knowledge and extranet Productivity improvement toolkit Process automation Our value Global delivery Unparalleled expertise Largest offshore team of revenue cycle experts and certified coders Delivery centers in India, Philippines and the U.S. Value beyond the servicelevel agreement Institutionalized account practices Transition methodologies Continuous communication Focus on issue resolution Strong governance model Account Intellectual property and revenue cycle knowledge Intellectual property V-Code, Code Finder Coding training program Centricity experience 14+ years of experience and 300+ successful transitions Figure 3: Key features and benefits of Revenue Cycle Services As a trusted provider of revenue cycle solutions, NTT DATA delivers proven results to many provider organizations. Whatever the condition of your organization s revenue cycle, we provide you with benefits such as: Access to state-of-the-art revenue cycle technology for enhanced performance Long-term relationships that provide cost predictability, risk sharing and unmatched results Higher returns on investment resulting from one of the highest recovery rates in the industry Measurable and sustainable improvements using key revenue cycle performance indicators Customized solutions that combine onsite and offsite staff to ensure quick resolution and maximum cash recovery Proven computer conversion projects Utilization of best-practice processes and metrics for lasting improvements in revenue cycle performance We can begin any project rapidly to create your revenue cycle infrastructure and allow you to focus cash flow quickly. The net cash collection rate we provide to our clients is second to none. With a consistently high rate of resolution on receivables, our results speak for themselves. We also leave you with lasting business process improvements by offering best practices to identify and help resolve policy, procedure and system factors that can delay payments. In addition, our professional and streamlined processes help create more positive and effective payer/patient relations. 4

5 Conclusion Understanding the full scope of opportunities you have within your revenue cycle is key to determining the level of service you need. Get started with a revenue cycle performance review from NTT DATA, which provides an in-depth analysis of all facets of your business and can set you on the path to reducing costs and increasing cash flow. With our experience with end-to-end solutions, we can help with whatever you need from isolating and providing a detailed analysis of one phase of the revenue cycle, to analyzing the entire revenue cycle work stream which allows you to focus on delivering world-class healthcare. Visit nttdataservices.com to learn more. NTT DATA partners with clients to navigate and simplify the modern complexities of business and technology, delivering the insights, solutions and outcomes that matter most. We re a top 10 global IT services and consulting provider that wraps deep industry expertise around a comprehensive portfolio of infrastructure, applications and business process services NTT DATA, Inc. All rights reserved. March 2017 NTTD1162-revenue-cycle-mgmt-svcs-brochure.indd Rev. 1.0