You would likely agree that underpayments are a constant irritant for your accounts receivables (AR) staff. Factoring in the ever-escalating reporting obligations and the complexity of medical billing, you may get a migraine from analyzing your clinical revenue cycle.
But with Zero Balance solutions from CorroHealth, you’ll secure your hospital revenue and dodge the burdensome and time-intensive process of identifying, researching, appealing, and collecting payer underpayment. With CorroHealth’s zero balance services, you enjoy these critical receivables solutions:
Contingency-Based Underpayment Solution
From the first point of contact where you determine patient liability, to service delivery, to the last point where you bill payers, many errors can seep through and result in an underpayment. For instance, if your AR team captures the wrong CPT code when billing, you’ll get a claim denial or underpayment.
Zero balance solutions help you get ahead of common loopholes that result in underpayments. These include:
Incorrect, outdated, or missing clinical documentation
Erroneous or illusive contract terms
Contrasting interpretations of contract terms between you and the payer
These subtle discrepancies often result in grave underpayment errors if not picked out and course-corrected early. Even with a competent AR team, the error margin is still significant, given the taxing nature of underpayment risk assessment.
That’s why you need a third-party vendor partner like CorroHealth to help with underpayment risks and lay out mitigation strategies. And we’re not all talk. Within the first year of consultancy, we have delivered:
for a large acute care hospital
for a 400+ bed urban hospital
for a multihospital system
for a physician-owned hospital
A more incredible fact is that we managed these gains as a contingency-based solution focused on less than 1% of closed claims reviewed by CorroHealth.
Research and Verification of Payer Underpayment
Identifying possible underpayment risks serves as your hospital’s first line of defense. However, when there’s an underpayment, you must research it extensively to tie it to its root cause. This is a complex process because payers take a highly systematic approach to reimbursements.
It takes more than proprietary algorithms to spot, research, and verify underpayment errors. You need an experienced team of healthcare AR experts working with cutting-edge technology to comb through individual accounts and pinpoint underpayment errors without missing any. This is what zero balance solutions offer you.
Contractual Payment Audit
Identifying the proper contractual reimbursement can be challenging. You can lose a significant amount of your revenue if you don’t fully understand the contractual terms with your payer. Many factors can affect contractual payment accuracy. Our service identifies charge, coding, and contractual opportunities for positive impact to contractual revenue yield.
Fortunately, our contractual payment audit reports will help you keep your financial books in order so you can build a healthy clinical revenue cycle.
Follow-Up, Denial Management, and Collection
Lastly, zero balance solutions streamline underpayment reimbursement collections. Payers often get a bad rep when it comes to reimbursements because of their slow-acting nature.
Zero Balance: Do Less and Get More
With CorroHealth in your corner, you won’t stress about identifying and researching underpayment errors or tracking and collecting your reimbursements because we’ll do all the legwork and dutiful paperwork for you. This way, you and your team can focus on daily operations of your revenue cycle without leaving revenue on the table from underpayments.