Using a comprehensive initial assessment, re|solution identifies areas where a facility has not received full reimbursement. re|solution guarantees its assessment and implementation costs will be covered by additional reimbursement identified. re|solution then works with departments quarterly to improve documentation and coding practices to ensure full payment. It also monitors implementations for a year. Again, costs are covered by additional reimbursement. The program provides rural hospitals assistance with revenue cycle issues and a "safety net" to ensure receiving all money owed.
- Over 12 years of experience in operations management for BPO healthcare and insurance companies, including leading teams of up to 500 employees
- Experience building and delivering business processes, managing SLAs, and driving process improvements that increased revenue and achieved cost savings
- Educational background includes an MBA in finance and certifications in Lean Six Sigma and healthcare administration
- Current role is as a senior operations manager at InfosysBPO where responsibilities include service delivery, people management, business and financial management, and ensuring regulatory compliance
Saillasri Ramachandran is seeking a Team Manager or Operations Manager position. She has over 15 years of experience in operations and service delivery roles. She is highly motivated and has excellent management and leadership skills. She has a proven track record of consistently hitting targets, improving processes, and organizing time efficiently while leading teams of 12 or more. She possesses strong conceptual, technical, and human skills developed through various roles in database configuration management, billing, reporting, and incident management.
Varun Kumar has over 11 years of experience in operations management, process management, client relationship management, and data management. He has worked at AON Services India Pvt. Ltd. for over 11 years, currently as an Assistant Manager in the Retirement department. His responsibilities include MIS operations, process management, and providing support to management. He has led various projects focused on business operations, quality improvement, and reporting and analytics.
Lean Kanban India 2016 | Kanban – Common sense in a new light | Ashok Kumar M...LeanKanbanIndia
This document discusses Kanban, a lean methodology for managing workflow. It emphasizes continuous flow, limiting work in progress, visualizing workflow, and establishing a learning culture. Key aspects include establishing daily stand-ups and visual boards to manage workflow, addressing bottlenecks, balancing workloads, establishing roles like dispatcher and chess master, and using metrics and retrospectives for continuous improvement. The goal is to establish collaborative problem solving, fast information flow, and adaptive capabilities through continuous learning and feedback.
Stephanie Ward has over 20 years of experience in administrative, project management, and leadership roles. She has a track record of developing high-performing teams, improving processes, and achieving cost savings. Currently she is a Clerical Coordinator and Administrative Manager at Danbury Hospital, where she led staff, implemented new customer service standards, and oversaw a facility renovation.
Vikas Shrivastava has over 16 years of experience in business process management, quality management, and customer service. He is currently a Senior Manager of Business Excellence at Reliance Life Insurance, where he manages their ISO 9001:2008 certification, business process management system, and customer service quality. Previously, he held roles at Development Credit Bank and Churchill India focused on operations quality, training, customer service and claims processing. He has a Green Belt in Lean Six Sigma and is a Lead Auditor for ISO 9001.
This document is a curriculum vitae for Vaibhav Sawant that summarizes his career experience and qualifications. It highlights over 8 years of experience in service delivery and continuous service improvement, including his current role as a Major Incident Manager at Tata Consultancy Services. It also lists his ITIL and Lean Six Sigma certifications as well as a Bachelor's degree in Computer Science.
This document outlines the responsibilities and experience of an Assistant Manager of Operations. Some key points:
- The individual manages a team of 180 employees and is responsible for meeting SLAs, improving processes, ensuring quality standards, and monitoring team performance.
- Previous experience includes managing teams of up to 120 agents across various clients and processes like customer care, order management, and promotions.
- Responsibilities involved meeting KPIs, handling escalations, training agents, and improving metrics like average handling time, idle time, and customer satisfaction.
- Achievements include improving retention rates, error rates, quality scores, and recognition from clients for effective management and business results.
- Over 12 years of experience in operations management for BPO healthcare and insurance companies, including leading teams of up to 500 employees
- Experience building and delivering business processes, managing SLAs, and driving process improvements that increased revenue and achieved cost savings
- Educational background includes an MBA in finance and certifications in Lean Six Sigma and healthcare administration
- Current role is as a senior operations manager at InfosysBPO where responsibilities include service delivery, people management, business and financial management, and ensuring regulatory compliance
Saillasri Ramachandran is seeking a Team Manager or Operations Manager position. She has over 15 years of experience in operations and service delivery roles. She is highly motivated and has excellent management and leadership skills. She has a proven track record of consistently hitting targets, improving processes, and organizing time efficiently while leading teams of 12 or more. She possesses strong conceptual, technical, and human skills developed through various roles in database configuration management, billing, reporting, and incident management.
Varun Kumar has over 11 years of experience in operations management, process management, client relationship management, and data management. He has worked at AON Services India Pvt. Ltd. for over 11 years, currently as an Assistant Manager in the Retirement department. His responsibilities include MIS operations, process management, and providing support to management. He has led various projects focused on business operations, quality improvement, and reporting and analytics.
Lean Kanban India 2016 | Kanban – Common sense in a new light | Ashok Kumar M...LeanKanbanIndia
This document discusses Kanban, a lean methodology for managing workflow. It emphasizes continuous flow, limiting work in progress, visualizing workflow, and establishing a learning culture. Key aspects include establishing daily stand-ups and visual boards to manage workflow, addressing bottlenecks, balancing workloads, establishing roles like dispatcher and chess master, and using metrics and retrospectives for continuous improvement. The goal is to establish collaborative problem solving, fast information flow, and adaptive capabilities through continuous learning and feedback.
Stephanie Ward has over 20 years of experience in administrative, project management, and leadership roles. She has a track record of developing high-performing teams, improving processes, and achieving cost savings. Currently she is a Clerical Coordinator and Administrative Manager at Danbury Hospital, where she led staff, implemented new customer service standards, and oversaw a facility renovation.
Vikas Shrivastava has over 16 years of experience in business process management, quality management, and customer service. He is currently a Senior Manager of Business Excellence at Reliance Life Insurance, where he manages their ISO 9001:2008 certification, business process management system, and customer service quality. Previously, he held roles at Development Credit Bank and Churchill India focused on operations quality, training, customer service and claims processing. He has a Green Belt in Lean Six Sigma and is a Lead Auditor for ISO 9001.
This document is a curriculum vitae for Vaibhav Sawant that summarizes his career experience and qualifications. It highlights over 8 years of experience in service delivery and continuous service improvement, including his current role as a Major Incident Manager at Tata Consultancy Services. It also lists his ITIL and Lean Six Sigma certifications as well as a Bachelor's degree in Computer Science.
This document outlines the responsibilities and experience of an Assistant Manager of Operations. Some key points:
- The individual manages a team of 180 employees and is responsible for meeting SLAs, improving processes, ensuring quality standards, and monitoring team performance.
- Previous experience includes managing teams of up to 120 agents across various clients and processes like customer care, order management, and promotions.
- Responsibilities involved meeting KPIs, handling escalations, training agents, and improving metrics like average handling time, idle time, and customer satisfaction.
- Achievements include improving retention rates, error rates, quality scores, and recognition from clients for effective management and business results.
This document discusses call center audits and assessments. It provides an overview of traditional audit approaches and introduces a new online audit tool called Snapshotz. Snapshotz allows organizations to conduct self-assessment audits of their call centers online for a fraction of the cost of traditional onsite audits. It provides a structured process and templates to guide auditors through assessing over 600 data points across 8 sections. The goal is to identify improvement opportunities, benchmark performance, and help call centers achieve targets in areas like customer satisfaction, agent engagement, and revenue.
Shared services - A Strategic Cost Management PlatformSanjay Chaudhuri
Shared Services Platform (as self defining as it can be) promotes the idea of 'sharing' within an organization or group or may also be provided as 3rd party SBU services.
Creating a Single point of contact for all service deliveries, enabling Cost effective solutions, leverage Automation, optimize workforce and the Speed to fulfillment is the key to success of such organizations.
More and more companies are moving to such platforms and the success rate is very high.
The powers company overview insurance final revTyler Petz
The document summarizes the services provided by The Powers Company, a consulting firm that specializes in operational improvement. They take a holistic approach, focusing on both process efficiencies and behavioral changes. Their methodology involves analyzing a client's operations, identifying improvement opportunities, implementing solutions, and measuring results. They guarantee specific savings targets and return on investment. For insurance companies, typical results achieved include 30% reductions in costs and 70% decreases in backlogs or overtime hours.
The candidate has over 18 years of experience in revenue cycle services and management. She currently works as a Revenue Cycle Service Analyst and is seeking new opportunities. Her experience includes managing patient service contact centers and denial management teams. She has strong skills in provider relations, training, compliance, and project management.
Improving IT services by implementing best practices. Strategic approval with clear RACI. Details plan covering entire process to improve the efficiency of IT team.
RPO made simple omvat een serie publicaties welke dieper ingaan op het proces van Recruitment Outsourcing.
In deel 3 gaan we in op de voordelen van deze manier van recruitment. Zoals het hoort, is het grootste voordeel de mogelijkheid om u in contact te brengen met het toptalent. Maar u zal ook een aantal andere voordelen ervaren, waaronder verbeteringen in de kosten, risico's, en tijd die kwijt bent aan inhuur.
This document contains a resume for Sachin Kumar, who has over 12 years of experience in back-end operations and team management. Currently, he works as an Operation Lead for TCS Ltd., overseeing a team of 45 people providing IT support for ONGC Ltd. Prior to his current role, he held similar leadership positions at other companies such as CMC Ltd. and PCS Technology Ltd., where he was responsible for managing teams and ensuring customer satisfaction. His experiences include incident and problem management, process implementation, team management, and customer relationship management in accordance with ITIL frameworks.
Vijay Sadasivan is seeking a challenging position with 12+ years of experience in the BPO industry. He has held roles such as Process Site Lead and Team Manager where he was responsible for managing teams, meeting SLAs, and ensuring smooth operations. He has a strong track record of successfully leading process improvement projects to enhance efficiency. Vijay has expertise in account management, performance analysis, and staff training. He holds a CF1 certification and has experience working with clients such as Maersk, Zurich Financial Services, and Reliance Retail.
Arushi Manav Kathuria is seeking assignments in presales operations, customer service, risk management, billing, and customer accounting with a growth-oriented organization. She has over 14 years of experience in telemarketing operations, customer service, credit and risk management, billing, and systems implementation. Her experience includes roles at Getit Infomedia, Tata Teleservices, Virgin Mobile India, Reliance Communications, and E-Serve International. She is proficient in areas such as outbound telemarketing, customer service, credit and collections, risk and fraud control, and systems implementation and reporting. She holds a postgraduate diploma in planning and management and a bachelor's degree in economics entrepreneurship.
Elizabeth Fernandes is a professional with over 10 years of experience in business operations and client servicing. She has expertise in transfer agency operations, managing teams, and process management. Her technical skills include experience with various industry tools like ICON, EXP AG, and Microsoft Office. She holds an MBA in HR and B.Sc in Biotechnology and is seeking new opportunities.
Continual Improvement Process is required to adopt by almost every organization to compete in the market. This slide presentation will give you a brief overlook what it is? without going into details.
Software Maintenance & Support RationalizationFlexera
This document discusses software maintenance and support costs consuming a significant portion of IT budgets and the difficulty of reining in these costs without establishing standardized processes. It introduces Flexera Software's Software Maintenance & Support Rationalization offering which helps clients develop rigorous processes to optimize maintenance and support levels through assessments, developing methodologies, and knowledge transfer, typically achieving 6-15% cost savings. The service is a consultative engagement to accelerate development and implementation of robust rationalization processes.
The document discusses how auditors can increase profitability while maintaining audit quality. It provides guidance on setting audit fees, including exploring value-based and time-based fee methods. The key to greater profitability is improving efficiency through better planning, delegating tasks to clients, using technology, and maintaining quality. Auditors should regularly review and increase fees to cover costs while clearly communicating fees to clients.
Gopalakrishnan is seeking a senior managerial role with over 20 years of IT experience, including 13+ years of leadership experience managing technical support operations. He has a track record of achieving goals through data-driven processes and people management. His expertise includes process optimization, resource planning, quality assurance, and people development.
This resume summary provides information about Senthil Kumar, an IT professional based in Coimbatore, India. He has over 5 years of experience in roles such as Technical Lead and Infrastructure Technology Specialist at Cognizant Technology Solutions. Senthil has certifications in ITIL, Six Sigma Green Belt, and Project Management and has successfully led several process improvement projects. He is seeking a leadership role where he can apply his knowledge and skills in project management, process design, and team leadership.
Praveen Kumar has over 10 years of experience in the health and benefits domain. He is currently a Senior Analyst at ACS working on projects involving benefits administration and client services. Previously, he worked at Mercer India and Patni Computer Systems on processes related to benefits enrollment, billing, and customer support. Praveen has a bachelor's degree in arts and has received several awards for his work in quality assurance, process improvements, and client relationships.
Recruiting the Lean Way - Value Stream MappingPradeep Sahay
This document discusses improving the recruiting process at Company ABC through value stream mapping. It provides an overview of the current recruiting process, including assumptions about timelines and metrics. It identifies potential inefficiencies such as delays in requisition approval, a lack of sourcing strategy, and issues with candidate screening and assessment. The document proposes improvements like automating requisition approval, integrating applicant tracking systems with tools for sourcing and screening, and standardizing phone screens. Charts map the current and future state processes, highlighting goals like reducing lead time by 50% through techniques like kanban workflow and parallelizing screening with response management.
02 Practical Strategies of Conducting BIABCM Institute
This document provides guidance on conducting a business impact analysis (BIA). It discusses key BIA concepts and outlines the BIA process, including determining critical business functions, quantifying impacts and tolerable downtimes, identifying interdependencies, and seeking management approval of findings. The document also walks through a BIA questionnaire template and discusses minimum business continuity objectives, recovery time objectives, and recovery point objectives.
This document is a resume for Christie Arokiaraj Richards seeking a career in operations, customer service, banking, or a related field. The summary highlights over 13 years of experience in operations, process management, client relationship management, and team leadership. Specific experiences include operations management, process improvement, quality management, client relationship management, and team management for banking and financial clients. The resume provides employment history dating back to 2003 with descriptions of responsibilities and achievements in various roles.
This document is a Cochrane review that analyzes the use of antibiotics for treating, preventing, and managing whooping cough (pertussis). The review examines several randomized controlled trials that evaluate the effects of different antibiotic regimens on clinical outcomes like mortality, symptom remission, and relapse rates. It also assesses antibiotic treatment durations and use for prophylaxis. The review finds that antibiotics can reduce symptom duration and improve clinical outcomes for active infection, but that shorter courses appear as effective as longer ones. Antibiotics may aid in preventing infection if used as prophylaxis after exposure.
This document outlines strategies for improving prescribing practices to achieve better outcomes for chronic pain patients. It discusses the need for improved prescribing in both primary care and specialty clinics. Examples are provided of initiatives at Grady Health System, the Atlanta VA Medical Center community clinic, and the VA's Opioid Safety Initiative that have reduced opioid prescriptions through interprofessional education, universal precautions like regular urine drug screening, and increased use of alternative pain therapies. The goals of these programs are to enhance safety for patients on long-term opioid therapy and establish tapering protocols for high-risk patients.
This document discusses call center audits and assessments. It provides an overview of traditional audit approaches and introduces a new online audit tool called Snapshotz. Snapshotz allows organizations to conduct self-assessment audits of their call centers online for a fraction of the cost of traditional onsite audits. It provides a structured process and templates to guide auditors through assessing over 600 data points across 8 sections. The goal is to identify improvement opportunities, benchmark performance, and help call centers achieve targets in areas like customer satisfaction, agent engagement, and revenue.
Shared services - A Strategic Cost Management PlatformSanjay Chaudhuri
Shared Services Platform (as self defining as it can be) promotes the idea of 'sharing' within an organization or group or may also be provided as 3rd party SBU services.
Creating a Single point of contact for all service deliveries, enabling Cost effective solutions, leverage Automation, optimize workforce and the Speed to fulfillment is the key to success of such organizations.
More and more companies are moving to such platforms and the success rate is very high.
The powers company overview insurance final revTyler Petz
The document summarizes the services provided by The Powers Company, a consulting firm that specializes in operational improvement. They take a holistic approach, focusing on both process efficiencies and behavioral changes. Their methodology involves analyzing a client's operations, identifying improvement opportunities, implementing solutions, and measuring results. They guarantee specific savings targets and return on investment. For insurance companies, typical results achieved include 30% reductions in costs and 70% decreases in backlogs or overtime hours.
The candidate has over 18 years of experience in revenue cycle services and management. She currently works as a Revenue Cycle Service Analyst and is seeking new opportunities. Her experience includes managing patient service contact centers and denial management teams. She has strong skills in provider relations, training, compliance, and project management.
Improving IT services by implementing best practices. Strategic approval with clear RACI. Details plan covering entire process to improve the efficiency of IT team.
RPO made simple omvat een serie publicaties welke dieper ingaan op het proces van Recruitment Outsourcing.
In deel 3 gaan we in op de voordelen van deze manier van recruitment. Zoals het hoort, is het grootste voordeel de mogelijkheid om u in contact te brengen met het toptalent. Maar u zal ook een aantal andere voordelen ervaren, waaronder verbeteringen in de kosten, risico's, en tijd die kwijt bent aan inhuur.
This document contains a resume for Sachin Kumar, who has over 12 years of experience in back-end operations and team management. Currently, he works as an Operation Lead for TCS Ltd., overseeing a team of 45 people providing IT support for ONGC Ltd. Prior to his current role, he held similar leadership positions at other companies such as CMC Ltd. and PCS Technology Ltd., where he was responsible for managing teams and ensuring customer satisfaction. His experiences include incident and problem management, process implementation, team management, and customer relationship management in accordance with ITIL frameworks.
Vijay Sadasivan is seeking a challenging position with 12+ years of experience in the BPO industry. He has held roles such as Process Site Lead and Team Manager where he was responsible for managing teams, meeting SLAs, and ensuring smooth operations. He has a strong track record of successfully leading process improvement projects to enhance efficiency. Vijay has expertise in account management, performance analysis, and staff training. He holds a CF1 certification and has experience working with clients such as Maersk, Zurich Financial Services, and Reliance Retail.
Arushi Manav Kathuria is seeking assignments in presales operations, customer service, risk management, billing, and customer accounting with a growth-oriented organization. She has over 14 years of experience in telemarketing operations, customer service, credit and risk management, billing, and systems implementation. Her experience includes roles at Getit Infomedia, Tata Teleservices, Virgin Mobile India, Reliance Communications, and E-Serve International. She is proficient in areas such as outbound telemarketing, customer service, credit and collections, risk and fraud control, and systems implementation and reporting. She holds a postgraduate diploma in planning and management and a bachelor's degree in economics entrepreneurship.
Elizabeth Fernandes is a professional with over 10 years of experience in business operations and client servicing. She has expertise in transfer agency operations, managing teams, and process management. Her technical skills include experience with various industry tools like ICON, EXP AG, and Microsoft Office. She holds an MBA in HR and B.Sc in Biotechnology and is seeking new opportunities.
Continual Improvement Process is required to adopt by almost every organization to compete in the market. This slide presentation will give you a brief overlook what it is? without going into details.
Software Maintenance & Support RationalizationFlexera
This document discusses software maintenance and support costs consuming a significant portion of IT budgets and the difficulty of reining in these costs without establishing standardized processes. It introduces Flexera Software's Software Maintenance & Support Rationalization offering which helps clients develop rigorous processes to optimize maintenance and support levels through assessments, developing methodologies, and knowledge transfer, typically achieving 6-15% cost savings. The service is a consultative engagement to accelerate development and implementation of robust rationalization processes.
The document discusses how auditors can increase profitability while maintaining audit quality. It provides guidance on setting audit fees, including exploring value-based and time-based fee methods. The key to greater profitability is improving efficiency through better planning, delegating tasks to clients, using technology, and maintaining quality. Auditors should regularly review and increase fees to cover costs while clearly communicating fees to clients.
Gopalakrishnan is seeking a senior managerial role with over 20 years of IT experience, including 13+ years of leadership experience managing technical support operations. He has a track record of achieving goals through data-driven processes and people management. His expertise includes process optimization, resource planning, quality assurance, and people development.
This resume summary provides information about Senthil Kumar, an IT professional based in Coimbatore, India. He has over 5 years of experience in roles such as Technical Lead and Infrastructure Technology Specialist at Cognizant Technology Solutions. Senthil has certifications in ITIL, Six Sigma Green Belt, and Project Management and has successfully led several process improvement projects. He is seeking a leadership role where he can apply his knowledge and skills in project management, process design, and team leadership.
Praveen Kumar has over 10 years of experience in the health and benefits domain. He is currently a Senior Analyst at ACS working on projects involving benefits administration and client services. Previously, he worked at Mercer India and Patni Computer Systems on processes related to benefits enrollment, billing, and customer support. Praveen has a bachelor's degree in arts and has received several awards for his work in quality assurance, process improvements, and client relationships.
Recruiting the Lean Way - Value Stream MappingPradeep Sahay
This document discusses improving the recruiting process at Company ABC through value stream mapping. It provides an overview of the current recruiting process, including assumptions about timelines and metrics. It identifies potential inefficiencies such as delays in requisition approval, a lack of sourcing strategy, and issues with candidate screening and assessment. The document proposes improvements like automating requisition approval, integrating applicant tracking systems with tools for sourcing and screening, and standardizing phone screens. Charts map the current and future state processes, highlighting goals like reducing lead time by 50% through techniques like kanban workflow and parallelizing screening with response management.
02 Practical Strategies of Conducting BIABCM Institute
This document provides guidance on conducting a business impact analysis (BIA). It discusses key BIA concepts and outlines the BIA process, including determining critical business functions, quantifying impacts and tolerable downtimes, identifying interdependencies, and seeking management approval of findings. The document also walks through a BIA questionnaire template and discusses minimum business continuity objectives, recovery time objectives, and recovery point objectives.
This document is a resume for Christie Arokiaraj Richards seeking a career in operations, customer service, banking, or a related field. The summary highlights over 13 years of experience in operations, process management, client relationship management, and team leadership. Specific experiences include operations management, process improvement, quality management, client relationship management, and team management for banking and financial clients. The resume provides employment history dating back to 2003 with descriptions of responsibilities and achievements in various roles.
This document is a Cochrane review that analyzes the use of antibiotics for treating, preventing, and managing whooping cough (pertussis). The review examines several randomized controlled trials that evaluate the effects of different antibiotic regimens on clinical outcomes like mortality, symptom remission, and relapse rates. It also assesses antibiotic treatment durations and use for prophylaxis. The review finds that antibiotics can reduce symptom duration and improve clinical outcomes for active infection, but that shorter courses appear as effective as longer ones. Antibiotics may aid in preventing infection if used as prophylaxis after exposure.
This document outlines strategies for improving prescribing practices to achieve better outcomes for chronic pain patients. It discusses the need for improved prescribing in both primary care and specialty clinics. Examples are provided of initiatives at Grady Health System, the Atlanta VA Medical Center community clinic, and the VA's Opioid Safety Initiative that have reduced opioid prescriptions through interprofessional education, universal precautions like regular urine drug screening, and increased use of alternative pain therapies. The goals of these programs are to enhance safety for patients on long-term opioid therapy and establish tapering protocols for high-risk patients.
Information literacy is key for 21st century librarians. It involves skills like searching, retrieving, evaluating information from various sources and attributing information. It is a process that should be taught from schools through higher education and lifelong learning. With new technologies like mobile devices, libraries must explore tools like QR codes, podcasts and using existing tools in new ways to remain relevant to users. Librarians have an important role in student learning by assisting with information literacy development and embedding these skills in collaboration with academic staff.
Blue Cross Blue Shield of North Carolina (BCBSNC) needed to reduce costs in IT but at the same time increase responsiveness to the business units of this Health Care services company. In February 2012, their IT infrastructure operations and data center was outsourced to Fujitsu North America, but then BCBSNC needed to figure out how to manage the huge anticipated transformation to ITIL v3 and improved services, the contract, and the demand for services. This was their first major outsourcing engagement and it brought tremendous changes to the organization, both in the IT area and also in the company at large. At the 2013 IAOP Outsourcing World Summit, the speakers discussed this project, as well as the inception of the Enterprise sourcing office which was created at the same time. The development of the governance program, creation of the governance team, selection and prioritization of processes for deployment, organizational change and transformation approach, process development, and rollout of processes to ensure compliance were covered.
EMF Client Platform @ Modeling Symposium EclipseCon North America 2012JonasHelming
The document discusses the EMF Client Platform, which allows developers to create model-based applications by connecting their model to generated editors, views, dialogs and other UI elements with one click customization. It notes that the EMF Client Platform provides a navigator, editor, validation view and model workspace that are transparently persisted using technologies like XMI, EMFStore and CDO. More information can be found at the Eclipse project website emfcp.org or on Twitter with the hashtag #emfcp.
Ambrosia Life Sciences is a visionary, end to end service provider for Pharmaceutical, Biotechnological, Medical Device and Consumer Heath Industries in the areas of Marketing, Research and Medical Services. We meet the needs of healthcare clients and providers through scientific expertise, excellence in delivery and limitless dedication that sets up apart from the rest.
Rural and Community Hospital Revenue Cycle Serviceskarvinkuffer
re|solution provides revenue cycle management solutions to healthcare providers to improve cash flow and financial performance. They offer a variety of customized solutions including cash acceleration, interim staffing, system conversion support, training and mentoring, an insourced business office option, and a guaranteed revenue improvement program. Their approach involves an on-site presence, process improvements, staff education, and long-term support to ensure sustainable results for clients.
re|solution provides revenue cycle solutions to healthcare providers to improve cash flow and financial results. They offer customized on-site services including cash acceleration, staff training and mentoring, interim staffing, and insourced business office management. re|solution guarantees to increase net cash for clients by finding unpaid claims, improving processes, and establishing efficient operations.
Pamela Ellis has over 20 years of experience in healthcare revenue cycle management, patient access, and EMR/EPM implementation. She has held various leadership roles at healthcare organizations and consulting firms, managing teams and improving revenue cycle processes through initiatives like denial recovery, training development, and system implementations. Her background includes experience with revenue cycle assessments, interim management, and strategic planning.
Pamela Ellis has over 15 years of experience in healthcare revenue cycle management, patient access, and EMR implementation. She has held various leadership roles managing revenue cycle departments and teams, improving processes, increasing collections, and ensuring regulatory compliance. Her experience spans a variety of healthcare settings including hospice, laboratories, hospitals, and academic physician groups.
Brandon Garner has over 12 years of experience in management and customer service roles within the financial services industry. He has a proven track record of exceeding goals and initiatives related to loan collections, risk assessment, and loss prevention. Currently he is an Associate Manager at H&R Block managing multiple teams and seasonal staff. Previously he held Supervisor roles at US Bank and Chrysler Financial where he consistently delivered exceptional employee coaching and development.
Tina Hindo has over 15 years of experience managing healthcare operations and clinics. She has held positions such as Clinic Operations Manager, Care Center Manager, and Practice Administrator. In these roles, she oversaw all aspects of clinic operations including budgets, staffing, quality metrics, and projects. Her experience also includes managing billing offices and implementing new software and processes. She is proficient in various medical software programs and aims to contribute to excellence in patient care.
Stephanie Russolillo Gomez has over 30 years of experience in operations management for insurance and financial services companies. She has held leadership roles managing customer service centers and new business operations. Currently she is an Associate Manager at Prudential Financial, where she is responsible for the operational performance of new business teams and implementing digital service improvements.
Stephanie Russolillo Gomez has over 30 years of experience in operations management for insurance and financial services companies. She has held leadership roles managing customer service centers and new business operations. Her experience includes strategic planning, process improvement, workforce management, and driving operational performance metrics.
This document provides a summary of Pradeep Koli's career and qualifications. He has over 8 years of experience in HR operations, payroll management, client relationship management, and team leadership. Currently he works as a Payroll Consultant for Cap-Gemini India, where he leads the HR and payroll team and ensures service level agreements are met. Previously he has worked for Accenture and Hewitt Associates in payroll analyst roles, and began his career at I-Pay Clearing Services and Reliance Communications. He holds an MBA in HR and is Fundamental Payroll Certification certified.
Major J. Newsom has over 10 years of experience in collections and management for Fortune 500 companies. He has developed and managed multiple teams, created assessment reports, and ensured production targets were met. His experience includes positions such as Front End Collector, Back End Collector, Senior Operations Manager, Operations Manager, Talent Development Specialist, and Team Lead for various debt collection companies. He has experience training employees, developing improvement plans, and meeting performance metrics.
Stephanie Harris is seeking a role that utilizes her experience in facilities and business operations management. She has over 15 years of experience in operations management, customer service, and human resources. Her most recent role was as Facilities and Business Operations Manager at Wipro, where she oversaw a staff of 15 and managed various operations. She is looking to join a creative and technology-driven company where she can contribute her skills in project management, operations, and team leadership.
Jay Wash has over 15 years of experience in data analytics, project management, and customer service. He currently works as a Data Consultant providing support to hospitals on quality reporting and regulatory submissions. Previously he has held roles managing billing operations and resolving unpaid medical accounts. He has a proven track record of using data analytics to improve processes, enhance customer experiences, and ensure data integrity.
Subhash C has over 4 years of experience in compliance, operations, and finance roles. He has a MBA in finance and relevant experience at Herbalife India, DBOI Global Services, and ING Vysya Bank. His responsibilities have included KYC analysis, compliance monitoring, investigating transactions, and preparing reports. He is seeking new assignments where he can manage risk and help companies achieve profitable goals.
Prasu. D has over 4 years of experience in end-to-end order management and accounts receivable processes. She has worked for Genpact India Pvt Ltd as a Senior Financial Ops Analyst, where she led a team of 6 members and successfully transitioned and stabilized processes for WellPoint within 32 days. Previously, she worked as a Senior Accountant at Hypercube Design Centre Pvt Ltd for 2 years. She is skilled in Oracle PeopleSoft, SAP FI CO, and MS Office applications.
The document summarizes Sam Walton's view that customers are the ultimate bosses of any business. It states that customers decide a business's success or failure by choosing to spend their money there or elsewhere. As such, everything a company does should have the clear objective of pleasing customers.
Rafeeq Basha is an Operations Manager with over 8 years of experience in the ITES industry. He currently works for Omega Healthcare Management Services Pvt. Ltd. Rafeeq has a proven track record of strategic planning, project management, improving operations efficiency, and team building. His areas of expertise include project management, people management, streamlining operations, resource utilization analysis, negotiation, financial planning, and information management. At his current role at Omega Healthcare, Rafeeq has achieved high customer satisfaction, helped meet production targets, improved costs and margins, and consistently scored high on customer satisfaction surveys. Previously, Rafeeq has held roles such as Assistant Manager and Team Lead where he was responsible for quality metrics, process
Sherry Andreu is an experienced operations manager specializing in organizational analysis, design, and process improvement. She has over 20 years of experience in call center operations, quality assurance, underwriting, and project management. Her background includes managing teams and designing programs to increase efficiency, reduce costs, improve quality and customer satisfaction. She holds certifications in quality management, Lean Six Sigma, and various software programs. Currently she is an underwriting team manager at Citizens Property Insurance Corporation where she has led initiatives to improve staff performance, reduce errors, and increase production.
Mohammad Harris Hanif is seeking a challenging position that provides career growth opportunities. He has over 10 years of experience in benefits administration and financial analysis. Currently he is a Benefits Analyst at Aon Hewitt, where his responsibilities include project management, requirements gathering, user testing, and analyzing trends to improve processes. Previously he worked at BA Continuum India as a senior team member, where he prepared reports, managed reconciliations, trained new hires, and reduced the company's suspense balances. He has received several performance awards throughout his career.
R Kishore Kumar has over 15 years of experience in operations management, process management, data reconciliation, process improvement, and customer relationship management. He has held several leadership roles at RBS Business Services Pvt Ltd in Chennai, India, including Functional Consultant, Manager of Reconciliations, and Team Leader. Some of his key achievements include creating a workflow tool for process management, identifying process optimizations that saved two full-time employees, and successfully migrating reconciliation projects ahead of schedule. He has expertise in functional consulting, operations, and people management.
Vivek Sharma has over 15 years of experience in customer service and operations management roles. He has a proven track record of exceeding targets and leading teams. Currently, he is self-employed working with various banks as a mortgage loan agent. Previously, he held several managerial positions managing teams, processes, budgets and client relationships.
Similar to All Services 1 Page Collateral 040612 (20)
1. re|grip
re|grip
re|grip
Guaranteed Revenue Improvement Program
Guaranteed Revenue Improvement Program
Guaranteed Revenue Improvement Program
Overview
Overview
Overview
Using a comprehensive initial assessment of the revenue cycle, re|solution identifies areas where
the facility has not received the reimbursement for which it is entitled. The assessment looks at all
phases of the revenue cycle including: scheduling, registration, charge capture, coding, billing, col-
lections and reimbursement. The assessment will identify claims to be rebilled, changes in process
that will generate additional dollars and other opportunities to move towards a best practices reve-
nue cycle. re|solution guarantees that the cost of the assessment will be covered by opportunities
found for additional reimbursement.
Once the initial assessment is completed, re|solution works with two departments each quarter to
assist them in improving charge capture, documentation and coding practices to insure that the facil-
ity is being paid the correct amount for all services that are performed. In addition, for a year follow-
ing the assessment, re|solution will monitor the implementation of each recommendation to insure
effective implementation. Once again, re|solution guarantees that the cost of this quarterly imple-
mentation and monitoring is covered by additional reimbursement.
Challenge
Challenge
Challenge
The challenges faced by rural and community hospitals are enormous. The same charge capture,
coding and reimbursement issues that plague larger facilities also affect rural and community hospi-
tals with less resources to insure compliance and appropriate reimbursement for services provided.
re|solution’s re|grip program provides a safety net to insure that the provider receives all the monies
they are due.
Benefits
Benefits
Benefits
Using proprietary technology, interviews and a proven continuous improvement and monitoring
process, this no-risk program allows personnel at the departmental level to work with the revenue
cycle personnel in optimizing reimbursement. This is the key to an effective revenue cycle when
you can get the clinicians and the business people working together. The process also allows the
facility to explore other opportunities for improvement such as point of service collections, denial
management, self pay management, contract payment review and EHR implementation for mean-
ingful use. This safety net gives our clients the peace of mind that all services are being reimbursed
at an appropriate level.
For additional information:
Robin Bradbury
robin@ereso.com
toll free 800-355-0410
www.ereso.com
2. re|cover
re|cover
re|cover
Cash Acceleration
Cash Acceleration
Cash Acceleration
Immediate Cash
Immediate Cash
Immediate Cash
Other benefits include:
• Reduced days in A/R
• Improved bottom line
• On-site training
• Proprietary reporting tools
• Improved management information
• Sustainable results
• Peace of mind
Real Life Results
Real Life Results
Real Life Results
Carson Tahoe Regional Medical Center (“CTRMC”) is a 140 bed facility just south of Reno, Nevada.
With over 30,000 patient visits per year, CTRMC had a negative adjustment to their net Accounts
Receivable of nearly $6,000,000 when their management embarked on a process to find any and all
opportunities for cash and bottom line improvement.
re|solution was engaged in November 2006 and assigned all insurance accounts over 90 days.
During the first quarter of the engagement, cash collections were 40% higher than cash collections
for the same quarter in the prior year.
In addition, re|solution provided added services for CTRMC’s business office staff, such as training
in billing and follow-up techniques and a detailed revenue cycle assessment at no additional cost.
The hospital administration was ecstatic about the increased cash flow. The improvements identi-
fied and implemented by re|solution were continued after the engagement ended.
Methodology
Methodology
Methodology
• Experienced and knowledgeable analysts work your aged accounts
• On-site training and mentoring of your staff insures long-term improvements
• Inefficiencies identified and recommendations made for customized process improvements
• Safety net of re|solution resources provide post engagement support
• Post engagement quarterly benchmark reports verify your success
“The re|solution team was so helpful
and had so many good ideas that
they quickly gained the trust of the
full-time staff. Everyone was happy
to have them on board and soon real-
ized the value of their expertise.”
John Wilker, Chief Financial Officer
Portneuf Medical Center
3. re|source
re|source
re|source
Interim Staffing
Interim Staffing
Interim Staffing
Immediate Access to Proven, Qualified Personnel
Immediate Access to Proven, Qualified Personnel
Immediate Access to Proven, Qualified Personnel
Other benefits include:
• Cash increases with improved staff skills
• On-site knowledge transfer produces competent local employees
• On-site training/mentoring increases skill retention
• Temporary or long-term placements
Real Life Results
Real Life Results
Real Life Results
Lavaca Medical Center (“LCMC”) is a 25-bed community hospital in south central Texas providing a
wide range of inpatient and outpatient services. LCMC’s business office manager resigned in 2002.
Months of searching for a replacement resulted in no qualified candidates, so LCMC identified an
individual from another department to become the new business office manager.
re|solution was engaged to mentor/train the individual selected. During the first three months of the
engagement, the on-site re|solution interim business office manager managed the business office
while the new business office manager shadowed and learned effective business office manage-
ment. During the second three months, the new business office manager managed the business
office and the on-site re|solution interim business office manager provided support while writing
policies and creating a reporting structure.
During the six month engagement, LCMC also underwent a difficult system conversion. Cash re-
mained relatively steady even with the turnover and system conversion problems. The new business
office manager received continued support from the re|solution interim business office manager
who remained a resource after the training/mentoring engagement ended.
Methodology
Methodology
Methodology
• You select from our elite reserve of qualified personnel
• Mentoring option for training managers or higher level personnel
• Implementation of unique reporting and productivity tools with monthly reports to measure em-
ployee performance
• Safety net of re|solution resources provide post engagement support
“Your placement of an interim business office manager helped us begin the process
of implementing the recommendations made in your assessment. Your continued
support in the months following the engagement, including assistance in interview-
ing candidates for permanent business office manager, enabled us to put the blocks
in place during this transitional period as we worked toward long-term stability.”
Bob Ellzey, President/CEO
Laird Memorial Hospital
4. re|train
re|train
re|train
Training and Mentoring
Training and Mentoring
Training and Mentoring
Improved Skills Increase Cash
Improved Skills Increase Cash
Improved Skills Increase Cash
Other benefits include:
• Training provided by highly skilled revenue cycle management experts
• On-site, one-on-one training insures retention
• Create well-trained staff without recruiting new personnel
• Application of proprietary software to monitor employee progress and performance
• Sustainable business office process improvement
Training Program
Training Program
Training Program
re|train is a cost-effective way to provide new or less experienced business office staff and manage-
ment with receivables management skills. The service is conveyed one-on-one by a re|solution
revenue cycle operations expert. Throughout the training, your staff completes a series of written
and oral exercises to verify comprehension and retention of the material. re|solution also applies
proprietary software to monitor employee performance.
Methodology
Methodology
Methodology
• Review and compare your facility’s key revenue cycle indicators to those of best practice organi-
zations, with instructions on how to use benchmarking to monitor, manage and improve busi-
ness office performance.
• A re|solution revenue cycle operations expert will provide in-depth instruction on:
◊ Bad debt and contractual reserves
◊ A/R management influences on the income statement and balance sheet
◊ Determining if changes in A/R are due to revenue fluctuations or process breakdowns
◊ Understanding the causes of key indicator variances and options for corrective actions
◊ Utilizing the Aged Trial Balance and other reports as management tools.
• Create a responsibility matrix that optimizes the skills of individual staff members in assignment
of key business office functions and processes.
• Develop performance expectations and productivity standards including prioritizing tasks and
developing effective time management strategies. Apply proprietary re|solution management
tools and motivational techniques to improve revenue cycle performance.
• Daily performance tracking, monthly site visits or calls to review progress and answer questions.
• Verbal exit conference and written report for hospital senior management at the conclusion of
the engagement.
5. re|store
re|store
re|store
Virtual Business Office
Virtual Business Office
Virtual Business Office
Guaranteed Performance Improvement
Guaranteed Performance Improvement
Guaranteed Performance Improvement
Other benefits include:
• No more staffing issues
• Dashboard reporting
• Implementation of new technology
• Peace of mind
Real Life Results
Real Life Results
Real Life Results
When Brownfield Regional Medical Center (“BRMC”) in NW Texas engaged re|solution in a cash
acceleration project, BRMC’s AR days outstanding were at 131, compared to a peer average of 48
days, the days of unbilled AR was at 27 compared to the peer average of only 10, and total AR was
at $4.5 million. Motivated by re|solution’s success in cleaning up the large backlog of old accounts
(down to just $2 million, BRMC’s CEO Mike Click determined that moving full operation of his busi-
ness office to re|solution was imperative to getting his hospital back on track.
re|solution assumed responsibility for BRMC’s 21 revenue cycle FTE’s in February 2002. During
the re|store engagement, re|solution was able to trim BRMCs business office staff to 10 FTEs,
making their revenue cycle much more efficient than ever before.
re|solution was also able to assist BRMC in returning to an in-house Business Office once opera-
tions were stabilized and BRMC desired to bring the work back in-house.
Methodology
Methodology
Methodology
• On-site and remote solutions tailored to your needs
• Option to manage and train current staff
• Optimize your current patient accounting system
• New technology upgrades and training provided
• Monthly productivity and benchmarking reports
“We had been without a busi-
ness office manager and our
issues were severe. The transi-
tion was relatively easy, and the
results practically immediate.
re|solution took over only the
necessary positions, trained
those we desired to have stay,
and the billing office began to
function efficiently. I can’t say
enough good things about our
experience with re|solution”
Mike Click, CEO
Brownfield Regional Medical Center
6. re|implement
re|implement
re|implement
ICD
ICD
ICD-
-
-10 Implementation
10 Implementation
10 Implementation
Transition Services to ICD
Transition Services to ICD
Transition Services to ICD-
-
-10
10
10
Other benefits include:
• Successful migration to ICD-10
• Coding accuracy
• Increased compliance
• Improved reimbursement
Challenge
Challenge
Challenge
Compliance and the transition to ICD-10 is in a state of flux with the October 1, 2013 deadline de-
layed to some point in the future. However, industry analysts agree that there will be a transition to
ICD-10 in the near future. The transition represents a significant impact to healthcare providers and
processes. ICD-10 code sets include updated medical technology and are more detailed and clini-
cally accurate. There will be an estimated 68,000 codes included instead of the current 13,000 in
ICD-9. It is necessary for providers to take steps now to mitigate the inevitable financial impact.
The transition to ICD-10 will be time and resource-intensive for all organizations. Every tool, system,
report and program must be adapted for ICD-10. Most facilities lack the resources to integrate ICD-
10 throughout every aspect of their business and coordinate clinical, financial, claims, analytical, and
especially, information technology.
The time to begin the planning and preparation for ICD-10 compliance is now. Regardless of any
delays that occur, ICD-10 is coming.
Methodology and Solution
Methodology and Solution
Methodology and Solution
Most ICD-10 consultants are performing this work for the first time as it is all new for the US. How-
ever, Canada and other countries have been using ICD-10 for years. re|solution has teamed up
with consultants who have done this work in Canada and have seen the process through from start
to finish. Our team will:
Review current state coding operations
Identify coding gaps across people, process and technology
Determine current staffing and training needs
Assess ICD-10 readiness and identify heavily impacted providers
Develop project implementation plan
Provide recommendations and risk mitigation strategies
Transition to owner
Put our experience to work for you.
7. re|charge
re|charge
re|charge
Charge Capture Review
Charge Capture Review
Charge Capture Review
Lost and Found
Lost and Found
Lost and Found -
-
- Cash
Cash
Cash
Other benefits include:
• Increased outpatient reimbursement
• Process improvement to capture all charges
• Reduce auditing costs
• Increased compliance
The Office of Inspector General of the Department of Health and Human Services has issued a re-
port indicating that it is doubtful that any hospital in the country is billing correctly for APCs, espe-
cially in the area of drugs. The Center for Medicaid and Medicare Services (CMS) has noted a num-
ber of services in which hospitals have not billed correctly for services. CMS has acknowledged
their errors in the payment of services and has requested hospitals to resubmit the claims containing
these services.
Real Life Results
Real Life Results
Real Life Results
DCH Health System in Tuscaloosa, Alabama is a three hospital system. Management realized that
with the large number of outpatient procedures it was nearly impossible to insure that all services
provided were actually billed. DCH contracted with re|solution in a re|charge program designed to
review two years of Medicare outpatient claims looking for uncaptured revenue. Over $715,000 was
found in additional cash reimbursement at DCH. In addition, several process improvement initia-
tives were started that assisted the facility in improving their charge capture processes in its cardiol-
ogy group.
Methodology
Methodology
Methodology
Using proprietary technology and a process which reviews all claims that have potential for addi-
tional APC reimbursement, re|charge will identify suspect claims, review the medical record associ-
ated with the claim and return a revised claim to the facility. All of this work is done on contingency
with no payment to re|solution unless additional dollars are found. A no risk program that helps
bring your billing back in compliance.
8. re|assess
re|assess
re|assess
Revenue Cycle Assessment
Revenue Cycle Assessment
Revenue Cycle Assessment
A Customized Plan to Improve Your Bottom Line
A Customized Plan to Improve Your Bottom Line
A Customized Plan to Improve Your Bottom Line
Other benefits include:
• Process improvement
• Comprehensive proprietary reports
• Increase cash and reduce AR
• Peace of mind
Real Life Results
Real Life Results
Real Life Results
Shenandoah Medical Center is a facility serving southwest Iowa for more than 80 years. When
re|solution was engaged to provide re|assess, their A/R over 90 days was increasing. Their new
business office manager, though strong in accounting and management skills, was new to the reve-
nue cycle.
With the participation of management, re|solution developed a comprehensive assessment which
included recommendations for A/R cleanup, management and staff training, and consulting in a vari-
ety of areas which ultimately led to a reorganization of their revenue cycle operation.
Based on the re|assess engagement, SMC reduced it’s days in A/R nearly 25% from 73 to 56 during
the project, had increased cash collections, and re|solution subsequently provided targeted training
for their staff and management, creating a foundation for their continued success and sustainable
improvements.
Methodology
Methodology
Methodology
• Observations, data review, and comprehensive interviews provide the basis for recommenda-
tions for improvement
• Results compared to peer group and best practices
• Action plan developed and presentation made to key management
• Implementation design and support
“We had just lost our Business Office Director and our A/R was growing. We en-
gaged re|solution to assist us. They proposed a comprehensive solution including a
revenue cycle assessment to identify root cause problems… The results were ex-
ceptional. In addition to the assessment, $2,500,000 in aged A/R was placed with
re|solution of which 92% was resolved. re|solution reduced our Medicare A/R over
90 days by 94% and collected nearly $800,000 in cash for us. re|solution’s onsite
consultant took the major recommendations from the assessment and worked di-
rectly with our revenue cycle staff to improve our operations.”
Chris Cronberg, CEO
Northern Cochise Community Hospital
9. re|search
re|search
re|search
Unidentified Payer Search
Unidentified Payer Search
Unidentified Payer Search
Overview
Overview
Overview
At the point of registration, obtaining accurate demographics can often be a challenge. Even with
today’s sophisticated software platforms, patient data accuracy can easily be compromised by
human error. re|search rapidly matches patient records to previously unidentified third party payers.
Identifying, correcting, and billing the claims which other automated third party payer validation ser-
vices miss.
Challenge
Challenge
Challenge
The portion of accounts receivable that is classified as patient responsibility is growing. The poor
economic environment, job losses (with accompanying loss of employer provided insurance) and the
overall climate of patients frequently changing insurance cause many patients to arrive at a facility
with a lack of insurance information. When the patient lacks the appropriate insurance information,
the claim generally ends up in the self pay bucket.
In our experience, from three to five percent of the claims within the patient responsibility bucket are
actually covered by third party insurance. The majority of these misclassifications relate to Medi-
caid, but there are also many Medicare and commercial insurances that are unidentified. This mis-
identification results in frustration to both the patient and the facility.
Solution
Solution
Solution
Using proprietary data mining technology that does not replace other Medicaid eligibility or collection
agency solutions, the re|search program continuously mines your registration information retroac-
tively and proactively searching for insurance programs that will cover patient responsibility balances
due. In addition, the technology will find additional DSH days that can be used to recover additional
monies through amended cost reporting.
re|search works because it is done strictly on a contingency fee where dollars are paid only on found
dollars and not on a per search basis. Once the claims are determined to be eligible, re|solution
will return the accounts to be billed to the hospital for billing or re|solution can bill the claims on the
hospital’s behalf.
The hospital experiences additional dollars from self pay accounts, reduced costs of chasing ac-
counts that are misclassified and increased patient satisfaction.
Results
Results
Results
Let us help you increase your reimbursements as we have for our clients listed below:
Hospital System
$800,000 recovered
120 Bed Hospital
$200,000 recovered
10. Disbursement Audit
re|solution uses proprietary sophisticated software developed by Oversight Systems that detects disbursement errors
other systems miss. Errors generally fall into one of three categories: duplicate payments, duplicate line items and
pricing not in accordance with GPO or other vendor contract terms. Such results have been proven in healthcare and
with non-healthcare clients such as MD Anderson, The Coca-Cola Company, Yahoo!, McDonalds, Martin Marietta,
Pfizer, Celanese, W. W. Grainger, and the Department of Defense.
re|solution identifies past payment errors for the prior three years, validates the errors with both the client and the
vendor, and then files claims for refund, credit or future discount.
Analyzing the payback for your hospital is simple. All you need to do is provide us data that is representative of your
past three years of disbursements. We will analyze your data and validate suspected errors and analyze the financial
impact. It is as simple as that, there is no cost to the hospital, and it will take just two meetings with you.
Getting Started Hospital Oversight re|solution
Provide Data
Analyze Data
Validate Errors
Present Findings
Go/No-Go
That is the upfront diagnostic. Running the ongoing project is just a simple continuation: You will provide re|solution
the same data as before on a regular basis. Oversight will use our analytics to detect the errors and re|solution will
validate the errors and prepare claims for vendor submission. You pay only for the claims and credits you actually
collect.
Hospital
Oversight
re|solution
Robin Bradbury
robin@ereso.com
toll free 800.355.0410
for additional information www.ereso.com
Confirm
Collection
File
Claims
Validate
Errors
Analyze
Data
Generate
Report
11. re|pay
re|pay
re|pay
Payment Review
Payment Review
Payment Review
Optimized Payments
Optimized Payments
Optimized Payments
Other benefits include:
• Contingency fee based service with no up front charges
• Additional cash
• Stronger negotiations of future contracts
• Peace of mind
Challenge
Challenge
Challenge
Are you certain payers are sending reimbursement that complies with the negotiated contract? Do
you currently use a post payment audit process to optimize and identify any reimbursement issues?
Contracts with payers are negotiated, discounts and payment terms change and errors in payment
occur for a number of reasons. Perhaps a contract amendment update was missed, or incorrect
proration applied. Employees posting payments may not have immediate access or time to review
revised contracts. A higher reimbursement rate may be missed for many months while the payer
pays at the old rate. re|pay identifies errors that cause reduced reimbursement.
re|pay will identify underpayments and inappropriate denials. Once identified, our analysts will ap-
peal underpaid and inappropriately denied accounts.
Methodology and Solution
Methodology and Solution
Methodology and Solution
• Payer contracts are reviewed and compared actual payments
• Identify accounts with underpayments and inappropriate denials for appeal
• Initiate proactive communication with payers to optimize reimbursement for identified accounts.
• Provide feedback on specific problem payers and specific contract issues
• Assists facility in staying current in payer contract renewals, updates, and billing policies.
• Monthly status reports of appealed claims
12. re|transfer
re|transfer
re|transfer
Transfer DRG review
Transfer DRG review
Transfer DRG review
Immediate Cash
Immediate Cash
Immediate Cash
Other benefits include:
• Identify additional reimbursement on TrDRG’s
• Improved payment accuracy
• Retrospective cash collection
• Sustainable results prospectively
• Peace of mind
Challenge
Challenge
Challenge
Many times a patient should receive post acute care and is discharged based on this recommenda-
tion from their physician. Medicare pays a reduced DRG payment based on the assumption that the
patient will comply with the physician’s recommendation. When a patient, for whatever reason, does
not follow through in receiving post acute care, your facility is entitled to the full DRG payment.
Facilities have no way of knowing that a patient did not follow through and that they should have
received the full DRG payment from Medicare. Using a proprietary software with algorithms to check
admissions and other medicare payments for each TrDRG patient, re|transfer identifies and assists
with rebilling of retroactive claims and continues to verify payments are not missed on a go forward
basis.
IT support is minimal and the service is provided on a contingency basis with no up front fees.
Methodology and Solution
Methodology and Solution
Methodology and Solution
• Identifies Medicare accounts that have a discharge status inconsistent with claims data
• Improves accuracy of claim payments for designated transfer DRGs
• Validates and documents that patients received post acute care
• Provides a conclusive list of claims that require review for possible rebilling and/or appeal
• Assistance with billing or re-billing of identified accounts
• Reporting demonstrates program’s effectiveness
• Monthly reporting on account statuses and identified issues
13. re|view
re|view
re|view
Candidate Screening
Candidate Screening
Candidate Screening
Identify Qualified Candidates Quickly
Identify Qualified Candidates Quickly
Identify Qualified Candidates Quickly
Other benefits include:
• Save time and money wasted on processing unqualified candidates
• Expert screening ensures candidate knowledge
• Identify candidates who will integrate seamlessly with your current staff
• Quickly identify permanent candidates
• Interim Staffing assistance available if needed
Screening Program
Screening Program
Screening Program
re|view is a cost-effective way to determine a candidate’s business office skills, and management
style. We work with you to asses the position criteria, and then use re|solution’s candidate screen-
ing to combine the best of competency-based selection with behavioral-based interviewing. Using
our competency analyzer, and conducting structured and action interviews, suitable candidates are
quickly identified. The program can be tailored to fit your budget and needs.
Methodology and Options
Methodology and Options
Methodology and Options
• Initial resume screening to pre-qualify candidates
• Qualified candidate screening using critical questions to further determine eligibility
• Detailed skills screen
• Detailed structured and action interview
• Report on individual candidate
Service Cost per candidate
Detailed Skill Screen $100
Detailed Structured and Action Interview $200
Candidate Report $100
14. Transcription Accountability
Transcription accountability management provides a powerful dictation/transcription workflow application that
includes a broad spectrum of capabilities for managing in-house, outsourced and speech recognition programs while
reducing costs and improving patient care quality. Historically reduces transcription costs by at least 17%.
PROGRAM FEATURES:
• Dictation and document tracking and management
• Advanced outsource and subcontract management module
• Line counting, with standardization and calibration
• Data analysis and reporting capabilities
• Software tracks transcription service utilization at the facility, department, location, and author
levels
• Integrated speech recognition services
• Unparalleled security insures access control, Protected Health Information (PHI), and activity logs
to meet compliance requirements
Predictability, Visibility, Transparency
Control—maintain control and accountability over document creation and management processes, PHI, and
compliance with user interface and data organization.
Cas h Savings —deliver optimal savings by structuring transcription operations. Usage based fee structure
delivers advanced proprietary technology that is continuously upgraded and professionally supported.
Quality—standardizes specifications, sets uniform templates, controls security and privacy policies, reduces
manual effort, and extends operational methods uniformly to current in-house and outsourced transcription
services.
Robin Bradbury
robin@ereso.com
toll free 800.355.0410
for additional information www.ereso.com