revcycle+ is the next generation of ed coding & billing
DESCRIPTION
T-System's RevCycle+ provides sophisticated technology with unparalleled client services -- transforming the process into a streamlined, technology-driven solution for physician coding and billing. We are the only company with the depth and breadth of experience and expertise across the entire ED process spectrum.TRANSCRIPT
RevCycle+™ The next generation of coding and billing
• Dallas, TX
• HQ, clinical content
and R&D COE
• Williamsburg, VA
• East physician
revenue cycle COE
• Kansas City, MO
• Facility coding COE
• Cerritos, CA
• West physician
revenue cycle
COE
• 39M+ patients each year
• Clinical, workflow and revenue
cycle solutions
T-System is everywhere emergency medicine is practiced.
Solutions for the Entire ED Care Process
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Notification,
handoff and
chart access
PCP referrals,
care plans and
patient transition management
PDI, eRx
follow-up
Utilization
review
Professional,
facility, CPT,
observation, ICD
POS collections, charge
capture, billing, denials,
collections
Patient access,
Published wait times,
pre-notification
Tracking, triage,
charting, orders,
admit, transfer,
optimization
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• Little automation
• Slower processing
• Accuracy relies on skill of
the individual coder or biller
• Limited performance
transparency
• Lack of education to
providers
Today, outsourced services are often performed
as they would have been 20 years ago.
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On average, EDs are only collecting 27% of
charges, and patient responsibility and self-pay
patients are increasing.
Identity & Insurance Verification
Pre-registration
Registration Charge Capture
Check-Out Coding Claims
Processing
Post Service
Payments Collections
Patient access Billing & collections
Co
llectio
ns
Percentage of Covered Workers Enrolled in a High-Deductible Plan
Note: These estimates include workers enrolled in HDHP/SO and other plan types. Because we do not collect information on the attributes of
conventional plans, to be conservative, we assumed that workers in conventional plans do not have a deductible of $1,000 or more. Because of
the low enrollment in conventional plans, the impact of this assumption is minimal. Average general annual health plan deductibles for PPOs,
POS plans, and HDHP/SOs are for in-network services.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2006-2011.
High-deductible plans are on the rise – estimated
70% of US employers in 2013.
T-System is Transforming the Process
Automating manual process for improved efficiency and fewer
errors
Real-time performance visibility to identify areas of potential
improvement
Client service expertise such as ongoing
provider training, payer contract negotiation
and credentialing
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RevCycle+™
| RevCycle+™
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Electronic eligibility
verification; claims, denial,
aging and collections
management; A/R
Advanced coding with
medical decision
making calculator POS collection
Patient responsibility & collections optimization, credentialing,
contract management, documentation training, compliance
+ Expert client services
+ Real-time visibility
+ Advanced technology
Advancing the Coding Process with Technology
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Audit report
Details how a level of service
was calculated
• Decrease the subjectivity
of code choice
• Create a defensible audit
report
Want to know how many
charts had no social history?
RC+ can report by provider,
by date, or other criteria
Reportable data
MDM calculation
• CT, lab, MRI, and more
• Utilization data by
provider
Ongoing Q/A
• Clinically trained coders
maintain consistency &
accuracy
Regulatory changes, ICD-10
expertise, payer guidelines
Bringing Sophisticated Collections Management
to the ED
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Predict patient
propensity to pay
based on historical,
local data
Tailor resources and
communication to
maximize collections
Estimate & collect
patient payment up front
1) 2) 3)
• Customize payment options
• Calculate real-time eligibility,
copay & deductible
• Capture patient satisfaction
• iPad enabled
• Define patient communication
plans, timing & methods
• Improve patient engagement
through specific activities
• Reduce risk of inappropriate
collection activity
Providing Real-time Performance Visibility
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• Real-time data
• Easy-to-use web interface
• Drill down, decomposition,
and more for analysis at all
levels of data
• Standard reporting pack
• Security features to specify
access by log-in
Delivering an Expert Level of Service
• Performance monitoring and proactive
identification of issues
• Ongoing physician training including ICD-10
training for providers, scribes, mid-levels
• Legal/compliance support
• Credentialing
• Contract negotiation
• Regulatory change monitoring
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T-System knows the
ED – and provides
service beyond just
coding & billing
30+ years of experience
in clinical, revenue cycle
and operational ED
management
