1. HealthTech Solutions Group
Company Overview
Optimizing Clients Financial & Revenue Cycle
Results through People, Process and Innovative
Technology Solutions
Albert Einstein
"The definition of insanity is doing the same thing over and over again
and expecting different results"
www.healthtechsolgroup.com
2. Company Profile:
Headquarters in Plano, TX (DFW Area)
Experienced management team
Proven results from CAH to multi-hospital systems
Focus on effective use of technology in driving performance
AR – Billing/Collections
Software – Business Intelligence, Claims Analysis
Services – Implementation, Revenue Recovery
AR/Central Business Office Synapse Software Suite Consulting – Services
Billing/Collections Business Intelligence Process Improvement
Revenue Recovery ED Claims Transfer DRG Recovery
AR reduction projects myClaimIQ genie Revenue Recovery
Outsourced BO Collection Management Interim Directors
www.healthtechsolgroup.com
3. Revenue Recovery Services
Case Study: ED Claims Project
Tool: myClaimIQ genie
“Our facility saw an almost immediate increase in net
revenue and cash collections from this project. The process
was seamless and the results speak for themselves ” –
CEO
Facility Overview - Results -
Critical Access Hospital 11% increase in Net Rev per account
$ 15 Million Annual Net Revenue over $300k recovered in first 6 months
~ 6,000 ED Visits per Year 4% increase in total facility annual NR
www.healthtechsolgroup.com
5. Outsourced Revenue Cycle
Why HealthTech Solutions Group?
Current Revenue Cycle Model HTSG Technology Focused Approach
Facility based Correct cash focused
Cash collections
AR Day focused
Revenue optimized - Synapse
Lack of scale in operations
Technology critical efficiency
Limited use of technology Centralized & scalable
Low level specialization Highly specialized functions
www.healthtechsolgroup.com
6. Accounts Receivable/RSC Services
What is “Correct Cash” focus?
Typical cash focus is on stated Accounts Receivable (AR) balance
HTSG Correct Cash focus:
1. AR balance is correct per contract terms and conditions
2. Claim has been correctly coded – Synapse ClaimIQ, ED ClaimIQ
3. Claim has all correct charge components – Implant charges, high cost
drugs etc
4. Claim has no codes that are incorrect, deleted or no longer in use
5. Claim is collected in a timely manner
Result – improvement in cash and cash
collected/account
www.healthtechsolgroup.com
7. Revenue Service Center (RSC) – Operations
Overview
Facility located in Plano, TX (DFW area)
Highly experienced & successful executive team
Currently perform operations for Brim owned hospitals
AR Liquidation projects – Physician & Hospital AR
All current staff highly experienced
Ability to expand scope of services without disruption
Location provides access to large pool of experienced
Revenue Cycle and Technology staff
DFW provides a very cost competitive value proposition
www.healthtechsolgroup.com
8. AR Liquidation & Recovery Services
A Service Redefined
Dedicated team & reporting portal for each project
Physician
Hospital
Project starts almost immediately via VPN connection
Team experience on all major hospital and physician HIT systems
Engagement structured as contingency fee basis
0-180 Days – 10%
181-365 Days – 15%
+ 365 Days – 25%
All claims run through Synapse ClaimIQ software ensures all revenue
captured
www.healthtechsolgroup.com
9. Revenue Recovery Services
Post Acute Care Transfer Recovery
CMS currently has 273 DRG’s subject to Transfer DRG rules
Payment to Acute Care hospital is reduced if the LOS (+1 day) is less than the GLOS
Can affect up to 50% of a PPS facilities discharges
HTSG researches all applicable Medicare discharges
Identify all accounts that have potential for Revenue Recovery
Work with facility to validate all information correct
Refile and correct all applicable claims
Revenue Recovery process is quick, seamless and no-risk to
the facility
Engagement structured as a contingency of recoveries (25%)
www.healthtechsolgroup.com
10. Revenue Recovery Services
Process Overview
HTSG provides each facility with a risk free assessment of potential
opportunity
HTSG will analyze previous 12 months of data for free
All we require is standard data file & BAA (HTSG can assist in data extraction)
Run the data through our proprietary algorithms
Turn the file around within 7-10 days
Process is extremely targeted and non invasive
Synapse ClaimIQ algorithms allow us to identify specific accounts
We don’t bring in a team of consultants taking up your team members time
Revenue Recovery can start almost immediately
Targeted approach means we can start rebilling accounts, capturing revenue within hours
of starting the engagement
ClaimIQ can provide ongoing monitoring and concurrent charge capture toolset
Engagement can be structured as either on a fee basis or as a
contingency (25%)
www.healthtechsolgroup.com
11. Accounts Receivable/RSC Services
Pricing Overview
Outsourced Billing/Collections – short term
provided on a per hr basis for short term projects
if longer than 90 days quote provided based on length
AR reduction projects
typically contingency fee (%) based on age & quality receivables
Physician and Hospital AR Reduction projects
Interim Business Office Directors
Synapse product suite provided free if project > 90 Days
Outsource Entire Revenue Cycle Operations
work with each facility to provide competitive quote
Revenue Recovery projects
25% contingency fee of $ recovered
focus on charging, coding, contract compliance
www.healthtechsolgroup.com
12. Synapse myClaimIQ genie
Revolutionary desktop Claim Analytic tool -
Downloads and installs in minutes – no IT involvement
Desktop application can be managed by anyone
Analyzes all billing claims instantly for:
Charge capture components – implants, procedures
Claims data integrity – all claim components are correct
Potential coding and documentation opportunities
CPT (CDM) audit for incorrect, deleted or non valid codes
Invalid combinations of codes
Facility has ability to run analytics on entire facility or sub-section e.g.
just ED if this is an area of focus
Charge is on a per claim basis – reduces cost increases value to client
www.healthtechsolgroup.com
13. Business Intelligence Services
Synapse Intelligent Analytics
Web based Business Intelligence application
Intuitive interface provides for easy analysis of operations,
AR, clinical indicators
Keep track of Key Indicators through KPI’s and dashboards
Real time access to information from aggregate level down
to patient detail
www.healthtechsolgroup.com
14. Synapse EDCalc
Application Overview
Correctly calculates E&M Level for every patient
Average increase in Net Revenue ~ $25 per patient
Ensures compliance with CMS 11 guiding principles
Level calculation documentation produced for audit purposes
Intuitive interface improves productivity
Chart analyzed potential charge capture opportunities that are
often overlooked
Missing procedures
Supply charges
Analysis of prior claims for revenue recapture opportunities
Improved revenue covers cost of application
www.healthtechsolgroup.com
15. Synapse ClaimIQ
ClaimIQ is an integrated collections and AR management tool created
to improve collector productivity and cash results in a Centralized
Business Office environment. ClaimIQ works with any hospital or
physician IT system and can be implemented as a collections platform
in days.
“Since implementing ClaimIQ for Brim Healthcare’s
owned facilities, we have seen a consistent increase
in cash collections and over a 100% increase in bad
debt recoveries in the first few months of
operations.” Brim Healthcare CFO
www.healthtechsolgroup.com
16. Synapse ClaimIQ
Application Overview
Integrated AR & Collections Management tool
Collections module provides real time productivity
monitoring
Work list management – specific focus problem areas
AR Analytics Portal with Business Intelligence toolset
Charge Capture Analysis tool highlights potential lost $
Charge Reconciliation Tool for Nurse Auditors
CPT Code Analyzer – corrects for deleted, invalid codes
Analysis of prior claims for revenue recapture opportunities
www.healthtechsolgroup.com