As the number of managed care contracts continues to rise, and the language in those contracts grows in complexity, tracking claim underpayments and denials of claims becomes more difficult. This generates revenue leakage for both hospitals and physicians. Underpaid or improperly denied claims from payers causes healthcare providers to lose millions of dollars each year.
When you invest in Concuity and/or the ClearContracts™ system to simplify the task of tracking and recovering lost dollars due to contract underpayments, you’ll find that it’s the best solution available in terms of service, software and results. Concuity combines its ClearContracts system with the industry expertise of our Revenue Recovery Services (RRS) teams to provide focused attention to claim underpayments, denials and “Silent PPOs”.
“We found Concuity’s delivery model to be extremely flexible, allowing us to meet our aggressive revenue objectives without having to increase resources or go through an extensive IT implementation.”
Bill Douglas, Chief Financial Officer, Riverside Medical Center
Enhance Your Bottom Line
Our RRS Team delivers industry-specific business intelligence resulting in “best practices.” Concuity’s RRS Team will analyze your contracts as well as your accounts to locate underpayments, possible trends and solutions. Once we identify any “at-risk” accounts, Concuity will take all of the necessary follow-up actions until the contractual payment is received. Because we use and own our technology (ClearContracts) Concuity will help you achieve immediate results.
Proven Process
Because we use our own technology, ClearContracts, to model your contracts, identify underpayments across all of your payers (both government and commercial), prioritize accounts and collect your money faster; Concuity is consistently seen as the best choice. Every one of our customers has seen a 1-3% increase in their net patient revenue due to our service and software.
Concuity has proven experience modeling contracts across all payers nationwide. Because of this expertise and coverage we can quickly input our customers’ contracts and begin to identify underpayments and denials within weeks.
Technology And Service Are Key
Our ClearContracts system is constantly being updated with the latest payer terms as well as the quarterly updates made to Medicare OPPS. This constant maintenance of our technology allows us to quickly update our customers’ contracts and keep up-to-date with new accounts being affected by new terms, thus allowing for better identification of underpayments.
Once accounts have been identified, Concuity staff will report all findings and progress throughout the recovery lifecycle. Our RRS Team has built relationships with many payers in order to assist in the recovery of underpayments. Additionally , Concuity will work closely with the customer to provide what ever is necessary to collect what is rightfully owed.
Benefits
Whether you are an existing customer experiencing staffing challenges, or a new customer wanting to bring in additional revenue, Concuity’s Revenue Recovery Services Team delivers measurable benefits.
- No upfront investment required for recovery services
- Recover cash from inaccurately paid accounts
- Identify systemic issues causing inaccurate payments (documented and communicated via ClearContracts)
- Recommend how to resolve systemic revenue-blocking issues in contracts or operations