Financial and Revenue Cycle Management Solutions
Payer Compliance. Accurate Reimbursement. Maximum Revenue.
Profitability begins with payment compliance. Each contract your healthcare organization has with a payer defines your reimbursement for all the services rendered to your patients and is the foundation for your revenue.
ClearContracts for Contract Management
Concuity helps healthcare organizations of all types to better manage these contracts and improve cash flow and revenue problems that plague the revenue cycle. Through our comprehensive suite of financial management tools and services, Concuity will help you optimize contract profitability, identify underpayments, correct business process errors, and negotiate better contracts.
“In less than 4 months, $1.37 million of underpayments had been appealed and $1.24 million of that actually collected. I have every reason to believe that we can increase revenues by $3-6 million annually using Concuity’s solution.”
—Mike Butler Chief Financial Officer, Providence Health System
Despite attempts to automate the contract management process, many technology and services vendors have yet to meet the needs and expectations of healthcare providers and medical institutions. The vendors fail to address the entire contract lifecycle, and focus instead on specific problems at the departmental level. ClearContracts sets itself apart! It goes beyond calculation engines, and gives providers the visibility and control they need to create and negotiate the best contracts, streamline contract interpretation and compliance, and collect what’s rightfully owed.
Our expert analysts can fully define and model the complex terms of each payer contract, giving you the enhanced knowledge you need for peak financial performance. When our reimbursement knowledge is combined with our web-based technology, medical groups can determine the value of claims before they are filed, verify reimbursement and improve cash flow.
Concuity Receivables Management
To effectively compete in today’s complex healthcare marketplace, you need the most flexible and powerful revenue cycle solutions available. To equip you with solutions that improve the financial well-being of your business, Concuity introduces ClearContracts™ for Denials and ClearContracts™ EOB Pro.
Industry studies show that approximately 25-30% of all health care claims are rejected or denied, resulting in millions of dollars of lost revenue each year. Add the lost productivity of employees "chasing" claims and the revenue hit is greater.
The majority of these losses can be avoided or recouped by using effective denial management software. For example, a typical 350-bed hospital can recover nearly $6 million dollars a year from denied claims, and a 300-physician group can recover nearly $3 million a year by deploying a denial management solution.
ClearContracts™ for Denials makes handling denied claims easy to manage through a comprehensive denial database and tracking system. ClearContracts™ for Denials is designed to support:
- All denial reasons and codes
- All denial appeal statuses
- Provider and payer responses to authorizations
- Concurrent denials
- All physicians and departments involved in the denial process
- Case-management notes
- Level of care determinations
- Identify revenue lost or at risk
The healthcare industry is one that remains in a constant state of flux, where challenges include: rising costs, pervasive inefficiencies, an ever-changing regulatory environment, and the constant demand to improve the quality and control of healthcare. An additional barrier to a collaborative healthcare environment exists - healthcare transactions, processing, and reconciliation.
ClearContracts™ EOB Pro provides a simple solution that eliminates time wasted on manually keying remittance data into patient accounting and ClearContracts systems. EOB Pro reduces the cost of manual posting and storing the paper EOB copies, and helps avoid the inconvenience and additional cost of retrieving and delivering those copies when the information is needed again.
ClearContracts™ for Documentation and Compliance
Concuity’s revenue cycle solution, ClearContracts, removes the challenges associated with the manual process of communicating and tracking contractual requirements by automating the contract itself.
ClearContracts™ Documentation and Compliance module eliminates the hassle of managing multiple filing systems by allowing you to scan contract documents and then store and catalog the images by payer, product, and effective date. With contracts and all associated documents stored electronically, it’s easy for your managed care, and other impacted departments to access the imaged documents and interpret contract language. And by using standardized payment mechanisms, you can easily interpret all rate schedules.
