Why top practices hand off billing
to NextGen RCM Services
Seven secrets to getting paid
2. “Revenue cycle management work takes diligence
to succeed. NextGen RCM Services digs into the
detail to truly understand the issues and works
closely with us to optimize collections. Whatever is
needed, we can count on NextGen RCM Services.
”Michael McManus, Chief Operating Officer
Touchette & Kenneth Hall Regional Hospitals
There’s too much at stake to let administrative
burdens hamper your ability to practice medicine
and financially thrive. With Meaningful Use (MU)
Stage 2, ICD-10, and an ever-changing healthcare
environment, it’s essential to have a proven technology
solution and partner that supports your regulatory
readiness and helps you resolve billing issues. The right
experts and technology will reduce your administrative
headaches and ensure you get every dollar you deserve.
4. Find a tailored billing solution
packaged in a flexible service
model to get support where
you need it most.
5. Is your practice struggling to handle time-
consuming tasks associated with medical billing?
In today’s complex healthcare environment, many practices are
struggling with medical billing and recruiting the talent required
to stay on top of billing rules. Outsourcing a part of the billing
process doesn’t need to mean downsizing staff or handing over
complete control of Accounts Receivable.
Services like NextGen®
Revenue Cycle Management (NextGen RCM) offer
a tailored billing solution with the flexibility to add resources only where you
need them to fix revenue leaks and optimize your bottom line. NextGen
RCM experts can help with as much, or as little, as needed. In some cases,
your practice may be growing faster than your internal billing staff can
handle. Or, you may not have the physical office space or the full
back office infrastructure needed to support the volume of claims and
credentialing associated with such growth.
Even if you’re not growing rapidly, NextGen RCM Services can help
you retain your staff in the face of change and intelligently re-engineer
employee responsibilities for optimal financial results. With a tailored
solution, rather than taking over the jobs of your current staff, you gain
expertise and support for time-consuming, repetitive billing tasks.
This allows internal staff to focus on higher value activities that can help
maintain and improve A/R, as well as more time to focus on care.
While partial medical billing service packages are a good choice for many
practices, they may not be the best choice for all. It may be more beneficial
for a practice to allow a medical billing service to actually “become” their
billing office, managing the entire claims process.
6. Choose an integrated solution
that covers the full RCM cycle
7. Do you have all the pieces in place for
a healthy bottom line?
According to the Healthcare Financial Management Association, RCM
involves managing both administrative and clinical functions related to
patient services. But not all billing solutions cover the full RCM cycle.
It is inefficient to switch from an RCM system to a practice management
system, and then, later, open your EHR. A truly integrated system
combines all of this functionality in an organized chronological order
to improve workflow and staff time spent on back end office issues.
This, in turn, will improve your bottom line.
NextGen RCM billing services provide you with everything needed
including EHR, Practice Management, Patient Portal, and appointment
reminder systems. With NextGen RCM Services, our experts ensure
you’re taking full advantage of top tier medical technology to drive
revenue to its fullest potential. Performance is based on more than
just the ability to manage A/R. A one-platform approach connects
and synchronizes the clinical, administrative, and revenue solutions
across all areas of a practice.
From the configuration of appointment reminders and eligibility
verification tools to claims processing, NextGen®
configured efficiently — accelerating revenue while saving time and
money. Denials and appeals are reduced significantly through tools
Real Time Edits (NextGen RTE) providing access to
thousands of the most current payer rules, enabling claim “editing” to
be invoked during the billing process. NextGen RCM Services experts
make sure required edits are applied, ensuring all claims are accurate.
As a result, billing conflicts are addressed immediately. With outsourced
billing, you can take advantage of our top tier technology, dashboards,
tailored processes, RCM best practices, and the advanced reporting you
need for complete control and A/R transparency.
NextGen RCM Services
billing processes and
tailored to your practice.
These methodologies are
easy to navigate and give
you a clear picture of how
fast you are getting paid,
who’s not paying you, and
why you’re not getting paid.
8. Pick a solution that supports
MU2 and ICD-10 readiness.
9. Is your technology partner MU2 certified? Are they
ICD-10 ready — and helping you get there, too?
The majority of EHR companies offering integrated billing services are not MU
Stage 2 ready. NextGen Healthcare is committed to helping clients meet
ongoing ICD-10 and MU goals—and offers the award winning technology
needed to help you get there quickly. As one of the first three EHR companies
in the nation to have an ONC Certified HIT 2014 Edition solution, we’re built
to manage change and keep you ahead of regulatory demands and risk-based
payment models. NextGen Healthcare is an industry leader and a safe, proven
choice in times of rapid change and uncertainty.
Your technology partner should demonstrate a commitment to client partner-
ships and proven solutions to help you secure stimulus incentives and meet
regulatory requirements. To date, NextGen Healthcare clients have claimed over
$440 million in MU payments. It is also important to look at the overall national
rankings of successful attestations, as well as the attestations success rates for
your specialty areas. Our proven robust system, with strong clinical/specialty
content, can help your practice fully meet MU attestation requirements. We
are consistently ranked in the top four by CMS.
NextGen Healtchare is
built to manage change.
ONC Certified HIT 2014
Edition and MU ready!
Our ICD-9/ICD-10 Comparison Utility
helps clients evaluate if, and where, they
need additional training on the new codes.
10. 4Demand an RCM partner
with proven results.
11. Does your prospective partner boast
A high-quality solution will revolutionize the way your company
operates and help you achieve greater efficiency and better
financial results. With a top-notch billing service like the one of-
fered by NextGen Healthcare, you can expect to reduce
average A/R days by 36% - 37%, to improve collections by 9% or
more, and achieve a first-pass clean claim rate of 97% or higher.
Your billing provider should be able to produce case studies
and proven metrics from actual customers showing measurable
results. NextGen RCM experts can deliver success stories and
offer a free assessment to help you assess your revenue cycle and
practice performance against state and national averages and
identify RCM improvement opportunities.
Our Clients Realize Amazing Results
• 33% improvement in first-pass clean claim rate
• 9% reduction in denials
• 42.7% increase in cash collections
Capital Women’s Care
• 81% decrease in A/R days to 21.47
• 99% Net Collections Rate
• MGMA top performer
Cincinnati Children’s Hospital
• Decreased A/R days to 20.31 (MGMA average 45.93)
• 89.6% of collections received in less than 30 days
• Aged A/R less than 1.79%
“We thought we were doing well with our clean claims rate before
but NextGen Billing Services increased our clean claim rate
more than 20 percent.
”Elisabeth Duhon, Director
Revenue Cycle Management
12. 5Reduce your administrative
headaches with an RCM partner
that quickly resolves issues.
13. “It starts out with RCM Services
working the denial as much as
possible and fixing it. Issues
such as inconsistent insurance
info or mismatched providers...
are identified and NextGen
RCM Services takes care of it.
With RCM Services, follow-up
time is as quick as possible.
They do an excellent job at
Keith R. Froleiks, COE, CMA,
Would you like to spend more time
Many RCM service providers say they will reduce headaches
and allow you more time to focus on practicing medicine.
However, they often task all the hard work back to you.
Look for a billing service like ours, which provides the
expertise and specialized advocates that will take on chal-
lenging tasks for you, like credentialing and denial resolu-
tion. As a billing partner, NextGen Healthcare proactively
drives revenue and prepares you for future change by finding
medical billing problems and taking care of them before they
ever come to you. In addition, we analyze your unpaid and
underpaid claims and aggressively follow up with insurance
companies. Continuously monitoring the ageing buckets
of your A/R, we keep in touch with insurance companies to
ensure that claims are settled as quickly as possible.
14. Partner with RCM experts who
will continuously drive results.
15. Do your financial results suffer because
there’s not enough bandwidth to effectively
Good talent is hard to find. Without the right IT systems and expertise,
you can lose patient care time as you struggle to better manage costly
revenue cycle issues like denials and claim errors. To achieve the best
results possible, find a provider with a consultative approach to billing.
One that brings RCM and technology experts together to provide the
intelligence needed to drive results.
Our experts meet regularly with clients and their staff, ensuring they
understand revenue cycle performance metrics, performance drivers,
and any trends that may help them respond to marketplace changes.
You get the expertise and strategic input to turn information into
actionable business insights. The NextGen RCM Services account
manager drives process improvements, system enhancements, and best
practices while acting as your financial analyst. They are experts at using
practice management software and healthcare information technology to
ensure your practice is using them to their fullest potential. They continuously
monitor your key performance indicators — such as your top denials —
providing detailed reports as well as action plans to help you optimize
reimbursements while reducing denials and days in A/R.
The NextGen RCM Services account manager drives
process improvements, system enhancements, and best
practices while acting as your financial analyst.
“Data is everything to us.
NextGen gives us situational
awareness so we can imple-
ment improvements. It all
works because we have the
right team internally and
externally with NextGen.
”Debbie Redd, CEO/President
Capital Women’s Care
16. Pick a flexible, value-based service
provider who won’t drain your wallet.
17. Are you getting every penny you deserve?
Today, keeping pace means not only driving better patient outcomes,
but also running a healthy business. Billing used to be simpler and
price was the driver in choosing a vendor. Today, the standard focuses
on value, results, and meeting ever-changing billing requirements.
Make sure you fully understand a given partner’s ROI potential. Too often,
when outsourcing billing, the promise of reduced overhead costs does not
pan out and the practice ends up disappointed. Flexible value-based
purchasing options offer a pricing model that is not fixed and is aligned
with a practice’s revenue cycle results.
Top practices choose NextGen RCM Services because of our pay for
performance ACO-type model, where we get paid when you get paid.
NextGen RCM Services also offers flexible value-based payment models
and supports alternative payment models—such as those that may
require HCC coding or population health applications.
When choosing a provider,
beware of emerging
ACO payment options
that have recurring standard
fees that can be quite high.
Minimize your risks and
make sure you fully evaluate
and negotiate terms and
don’t overlook any recurring
standard minimal fees that
other vendors may apply.
A year after our RCM transition, our billing
department team better values their roles and
is more knowledgeable about all aspects of
the billing process. There’s more cross-coverage,
PTO flexibility, and time for special projects.
We’ve stopped drowning in our holding tank.
Sarah Ortiz, Revenue Cycle Manager
19. Financially Thrive.
Reduce or eliminate administrative headaches. Ensure your ongoing
readiness for healthcare change. Tap into NextGen RCM Services to
empower your ongoing success.