Sutherland Healthcare Solutions

Provider Solutions

What is your TRUE RETURN?

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The financial strength you need to offer great patient experience today and tomorrow. Our healthcare experts are ready to partner with your team to create a custom, process-focused solution that is fast, accurate and designed to achieve your financial goals.

As an extension of your team, we tackle your challenges on any scale – whether a targeted solution to troubleshoot one part of your revenue cycle or a full-scale, sustainable platform for managing the entire process.

Our first-hand, specialized knowledge of the healthcare revenue cycle is reflected in everything we do. Apollo’s team brings personal experience as healthcare leaders around the country, as well as experience in delivering the results our partners need.

Our deep clinical domain offers unparalleled resources and experience

Six Sigma methodologies facilitate measurable process improvement, beyond

Blended shore delivery offers lower cost without sacrificing quality

ISO:9001 certification ensures strict quality management standards in our

conventional limits

Compliance program strictly adheres to HIPAA and other healthcare information regulations

daily operations

Advanced, intelligent software ensures a strong return on investment

End-to-end business outsourcing solutions span the healthcare market

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Apollo’s solution-focused partnership enhances your team’s resources every day. From pre-registration to bad debt pre-lists, our collaborative approach delivers long-term, sustainable results to your bottom line, and our speed to value is unsurpassed in the industry.

Complete and smooth transition, quick ramp-up to full productivity, positive

Qualified uninsured patients get help finding an alternative payment source

Policies and procedures that ensure fair and dignified collection for all patients

impact to cash flow, and timely billing of all third-party accounts

Resolution of denials and delays in third party payment processing, ensuring the best A/R metrics possible

State-of-the-art credit analysis, advice on patient payment agreements, and the best outcomes for self-pay collections

Full Revenue Cycle Outsourcing Solutions

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We quickly diagnose and fix specific processes that impact cash collections, allowing you to maintain control of the most sensitive parts of the revenue cycle. Apollo works on the more labor-intensive elements, such as the outpatient A/R, billing platform management, or credit balance resolution, so that you can focus its strengths on issues closer to your core mission.

Attention to your chosen areas of focus

Laser-like focus on a specific area of your revenue cycle

Minimal ramp-up time

Highly-trained, bi-lingual customer service specialists who carefully listen to every patient call and ensure the highest levels of satisfaction for your patient community

Focused Outsourcing Solutions

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With extensive experience in all major billing platforms and information systems, Apollo uses smart technology to work all third party accounts to completion. Our process-driven staff ensures the best use of tools and effective, comprehensive follow-up of accounts. Most importantly, Apollo never loses sight of the goal - increased cash collections and reduced days in A/R.

Management of all Return to Provider (RTP), Additional Documentation Request (ADR), and related information requests immediately

Root cause analysis of third party denials – by type, by department, by physician

Delays in payment addressed in the first 21 days

Work lists defined within 48 hours of receipt of the denial information

Sophisticated set of reports detailing “final denial” accounts

Third Party Solutions

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Our comprehensive medical coding meets the essential needs of hospitals, medical practices, and freestanding ambulatory surgical centers so that you are able to focus on your core mission of quality patient care. Apollo fills the gap, whether that is working the backlog, coding your ED accounts, pitching in for vacations, or outsourcing your entire coding department.

HIPAA-compliant electronic access to your EMR or courier exchange of medical records

Coding backlog support

AHIMA- and AAPC- certified coding teams with experience in your specialty areas

Documentation deficiency reports and physician documentation training

Pricing models that are lower than in-house costs

Medical denial appeals and RAC audit preparation

Medical Coding

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Combining our network of dedicated healthcare experts with smart mobile technology, Apollo’s EMS solution works quickly and efficiently bill and follow-up on every 911 emergency and non-emergency transports. Our team knows the unique, on-the-go needs of EMS providers and offers training on data capture for your EMTs to eliminate back-end billing and collection edit failures. From medical coding to remittance processing to customer service and carrier relations, we offer a customized billing platform to handle every patient interaction your team encounters.

detailed auditing and reporting

Customized development and installation of EMS-specific processes that include

Quick ramp-up to full productivity, positive impact to cash flow, and timely billing of all third party accounts

Advanced technology providing real time access to patient transport data

Dedicated, highly-qualified EMS service center accuracy ratings

Managing the most complex COB and subrogation claims, with timely follow-up for those requiring long-term status reviews and updates

EMS Billing, Follow-up, and A/R Management

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Utilizing proprietary workflow software, we retrieve and interpret denial information, review HIM documentation, and prepare compelling appeal packages for review by the payer. Our skilled clinicians review medical records on clinical denials to complete appeals, confirm receipt of the appeal, and demand claim disposition as quickly as possible. Apollo forwards technical denials to the clinical appeal team for medical necessity review and appeal, when warranted.

paper EOBs, and correspondence

Web-based technology sorts, refines, and evaluates denial details from 835s,

Easily exportable reports to basic desktop applications.

Timely and accurate workflow tracking

Pre-implementation assessment to maximize benefits

Billed A/R over 90 days ratio

Denial Management

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Your uninsured patient accounts have a critical impact to your bottom line, so we offer onsite financial counseling, casework completion, and field service assistance. Above all, Apollo handles collectible self-pay balances with dignity and fairness, working with the patient to establish reasonable payment plans. The result leads to reduced bad debt expenses by identifying and collecting accounts early.

Automated dialers, interactive voice recognition, and online auto-pay tools for ease of payment and payment plan monitoring

Careful review of each patient’s situation, using the patient’s financial and socialindicators to determine proper workflows

Process-driven, bi-lingual customer service representatives bring solutions to your patients’ problems, with one-stop calling

Collaborative approach with your Patient Access and General Accounting departments to ensure a timely and complete Medicare bad debt log for your cost report

Call recording for training, quality assurance, and compliance

Account scoring techniques specifically designed for healthcare collections, which helps protect the patients from undue collection efforts

Extended collection hours and patient-friendly payment technology

Private Pay Solutions

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Our Patient Access Partnership, a combination of technology solutions and services, addresses the inherent challenges present in Patient Access departments around the country. Apollo ensures a complete review of all your daily registration and corrects any errors in patient data – as well as demographics and other data that can impede the revenue cycle.

Accelerated receipt of outstanding revenue that is delayed due to registration errors

Error identification before the first bill is dropped

and pre-authorization failures

Cost to collect reduction, since errors are corrected prior to billing, rather than through labor-intensive review of EOBs, correspondence, and telephone inquiries

Employee scorecards to provide staff accountability and training

Robust internet-based reporting system to provide the data necessary for root cause analysis

Instant accountability and rapid staff feedback to allow proactive management

Patient Access Partnership

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Apollo helps providers tackle the challenges in upgrading to ICD-10 Coding standards through assessment, design, implementation, training, go-live, and beyond. This transition impacts clinical documentation processes, encounter forms/superbills, practice management systems, electronic health records, medical coding and billing, contracts, and public health and quality reporting protocols.

Fully customizable solution to meet ICD-10 compliance requirements

Secure hosting and/or in-house deployments

Initial cost estimates for the ICD-10 transition

End-to-end project management through all phases that include the assessment, strategy development, remediation, testing, and implementation

Increased understanding of ICD-10 implications on your operations and systems

Reduction of the potential negative impact to cash and productivity

ICD-10 Transition

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Apollo’s unique understanding of the hospital, physician, health plan, and healthcare IT segments allows us to help ACO’s quickly implement their setup process and manage costs while staying focused on quality patient care.

The path to creating and operating an ACO can be very complex depending on your current infrastructure, technology capabilities, and ACO requirements as per the Centers for Medicare and Medicaid and the American Hospital Association. Our proprietary technology tools and six-sigma based methodologies will help offset those costs by creating or enhancing your information technology and data analysis infrastructure.

Build prospective budgets and resource planning

Calculate performance metrics

Manage complex contracts

Effectively distribute shared savings

Accountable Care Organizations

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Apollo’s dedicated team of eligibility advocates, financial counselors, and field resources staff helps patients navigate through the difficult eligibility process at every step, ensuring that your patients receive the highest level of dignity and respect. Our patient-friendly billing philosophy improves patient satisfaction, positively impacts cash flow, and further reduces bad debt.

Legitimate third-party accounts like worker’s compensation and liability to immediately reduce bad debt

Medicaid eligibility to link the patient to the applicable state or federal program that best suits the patient’s financial and medical status

state-sponsored assistance, hospital-based community benefit programs, county

Proprietary workflow management software to ensure timely and compliant work

Medicaid billing to ensure timely payment from the state on all accounts under our supervision, further reducing bad debt by converting previously branded self-pay accounts to Medicaid

Support programs available to non-federally-sponsored patients, including and local funding, and other sliding-scale patient discount programs

Timely reports on all accounts assigned to ensure minimal impact on accounts receivable

Medicaid and Patient Advocacy Solutions

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Timely billing of all accounts is a cornerstone of an effective revenue cycle, and ensuring that all bills are submitted with the correct information is an underlying goal of any billing department. Once a bill is submitted, timely and appropriate follow-up across the entire A/R process will play a major role in ensuring that the total cash reimbursement is maximized.

Unique insight into the “upstream” areas that are the underlying causes of

Identification and tracking of errors prior to claim submission to minimize delays

Propietary workflow management and reporting tools, which incorporate our

downstream billing delays

best-in-class A/R follow-up techniques

Systematic account management process ensures all claims are worked timely - regardless of amount outstanding

Patient Accounting Services

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Apollo provides a variety of qualified professional consulting services to support physician practices. Our team offers web-based claims processing, enrollment assistance, training and implementation, and business office support to help your office run smoothly so you remain focused on patient care.

Implementation of internally developed Health Level 7 (HL7), an ANSI-accredited standard for electronically defining clinical and administrative data in the

Eligibility verification where the provider, payer, and user details are setup and

healthcare industry tool

Integration of clinical and patient demographics with EHR

PM and EHR data conversions, including demographics, clinical data, encounter notes, and document and image conversions

the client is then trained on how to check on eligibility

Physician Consulting Services

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We offer a full array of technologies to deliver accurate transaction services at the highest quality level. Solutions range from the most basic double-key data entry work to the most sophisticated electronic transaction processes. Apollo brings a depth of experience and relationships with many technology platforms to deliver our solutions cost-efficiently.

Remote desktop with the most sophisticated VPN (Virtual Private Network) tunnels to send and receive secure, accurate transactions

Completely digitized payment records (paper EOBs, various correspondence, etc) as well as 835s, to automate cash posting

Leading-edge experience in physician and hospital coding using ICD-10-CM conventions

Transaction Service Solutions

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Contact Us TODAYTo Learn More

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www.sutherlandglobal.comWebsite

SGS.Healthcare@sutherlandglobal.comEmail

+1-800-388-4557Phone

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