HealthTech Revenue Cycle and Technology Services - driving innovation in revenue cycle

1. HealthTech Solutions Group
Company Overview
Optimizing Clients Financial & Revenue Cycle
Results through People, Process and Innovative
Technology Solutions
Albert Einstein on Insanity:
"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 Charge Capture Revenue Recovery
Outsourced BO Collection Management Interim Directors
www.healthtechsolgroup.com

3. Revenue Recovery Services
Case Study: ED Claims Project
“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

4. Accounts Receivable/RSC Services
Services Overview
 Interim BO placements – BOD, Manager Level
 Outsourced Billing/Collections
 Aged AR Liquidation/Reduction Services
 Hospital
 Physician
 Physician Billing/Collections
 Outsource Entire Revenue Cycle
 Revenue Recovery projects – charging, coding
 provided on a contingency fee basis
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. 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

13. 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

14. 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

15. 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