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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 Entire ED Care Process
3
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
4
• 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.
5
Current collections rate averages 27% with
growing self-pay/no-pay populations.
Identity &
Insurance
Verification
Pre-
registration
Registration
Charge
Capture
Check-Out Coding
Claims
Processing
Post
Service
Payments
Collections
Patient access Billing & collections
Collections
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
training, payer contract
negotiation and
credentialing
7
RevCycle+™
| RevCycle+™
8
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
T-System clients increase collections by $10-30 per patient visit
$500,000 to $1.5 million per year.
Automating the Coding Process
9
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 Collections Management
Sophistication to the ED
10
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
• 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
11
• 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
12
T-System knows the
ED – and provides
service beyond just
coding & billing
30+ years of experience
in clinical, revenue cycle
and operational ED
management
info@tsystem.com
(972) 503-8899
Contact us today for a free assessment.

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RevCycle+, the next generation of coding & billing.

  • 1. RevCycle+™ The next generation of coding and billing
  • 2. • 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.
  • 3. Solutions For Entire ED Care Process 3 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
  • 4. 4 • 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.
  • 5. 5 Current collections rate averages 27% with growing self-pay/no-pay populations. Identity & Insurance Verification Pre- registration Registration Charge Capture Check-Out Coding Claims Processing Post Service Payments Collections Patient access Billing & collections Collections
  • 6. 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.
  • 7. 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 training, payer contract negotiation and credentialing 7 RevCycle+™
  • 8. | RevCycle+™ 8 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 T-System clients increase collections by $10-30 per patient visit $500,000 to $1.5 million per year.
  • 9. Automating the Coding Process 9 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
  • 10. Bringing Collections Management Sophistication to the ED 10 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 • Capture patient satisfaction • iPad enabled • Define patient communication plans, timing & methods • Improve patient engagement through specific activities • Reduce risk of inappropriate collection activity
  • 11. Providing Real-time Performance Visibility 11 • 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
  • 12. 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 12 T-System knows the ED – and provides service beyond just coding & billing 30+ years of experience in clinical, revenue cycle and operational ED management
  • 13. info@tsystem.com (972) 503-8899 Contact us today for a free assessment.