The traditional healthcare revenue cycle process involves medical claims submitted to one or two commercial and/or government health insurers that are reimbursed for a full contractual reimbursement. Complex claims management, however, involves many more steps. Many claims involve multiple payers, a claims investigation, and possible legal action pertaining to the accident that prompted the medical care. These accident and injury claims involve third party liability, motor vehicle accidents, workers’ compensation, and other cases, which can consume much more time for healthcare organizations than traditional billing and collections. Complex cases frequently require negotiating with attorneys or claims adjusters, meeting stringent state and federal guidelines, and submitting numerous and lengthy legal documents to a court of law. RevClaims’ highly specialized healthcare revenue cycle management (RCM) service alleviates the burden of these time-consuming and frustrating claims from hospitals and health systems, so hospital staff can concentrate on their core RCM competencies while maximizing revenue.
Because revenues from these specific claims could be much greater for you. Hospitals and health systems face significant financial challenges with changing payment models, regulatory pressures, labor costs, and increasingly complex revenue cycle management. Due to the time involved with complex claims, many hospitals either do not pursue every reimbursement opportunity, or they write off these cases as losses altogether. Injury claims management, for example, if executed properly, yields reimbursements of up to 100 percent in many cases. The additional hospital revenue from complex claims can help offset financial challenges caused by declining reimbursements and increasing operating costs while supporting your optimal care and service to patients and their families.
If your in-house team is not achieving greater than 70 percent average reimbursement of charges on paid accounts – or if your overall TPL claims take more than 100 days to recover, partnering with RevClaims could improve both of these key performance indicators. RevClaims’ third party liability claims management services cover a much broader spectrum than just MVAs. For example, 500,000 burn cases, some of which involve product liability lawsuits, require health care each year. For such TPL claims, hospitals need guidance from attorneys and injury claims experts to save valuable time and maximize reimbursement. Collaborating with RevClaims not only increases revenue, it allows existing staff to focus on their core healthcare revenue cycle management competencies and superior patient-centered service.
No. Partnering with RevClaims allows your team to focus more time and attention where it is needed: traditional commercial and government payer revenue cycle management. You can relieve your staff from the learning curve as well as the time and frustration of dealing with third party liability, motor vehicle, and workers’ compensation claims, insurers, and attorneys. Instead, allow the highly skilled and experienced attorney-led teams at RevClaims to accelerate the process on your behalf for maximum revenue. The RevClaims technology platform provides complete oversight to your staff throughout the claims process and integrates seamlessly with your existing RCM solutions for maximum time savings.
In lien states, RevClaims is helping clients achieve 86 percent average reimbursement of charges on paid accounts.
Please contact us either by phone or e-mail. We will put you in touch with the RevClaims team most experienced in handling injury claims in your state.