What Can CHS Do For You?

CHS is a leading national provider of RCM support services and solutions. Our in-depth healthcare industry knowledge and experience enables us to provide innovative, end-to-end solutions to successfully resolve our clients challenges while enhancing their overall business operations.

We help clients succeed by leveraging on our deep industry knowledge and expertise, by a partnership approach, comprehensive service offerings, and a proven track record. CHS delivers highly skilled professionals, robust processes, proprietary workflow engines, and world-class infrastructure. This makes us an ideal partner for our clients. We provide strategic outsourcing solutions to healthcare providers. We optimize our client's revenue cycle by leveraging our people, processes and technology to reduce operating and capital costs, recover revenue, improve patient satisfaction and increase productivity and effective Denial Management

Hospitals and other healthcare practices have benefited by outsourcing following revenue cycle management services to us:

• Patient Demographic Entry

  We collect and verify the patient demographics received during the patient visit. In case, the patient is already registered in the medical billing system, new information is verified and updated swiftly.

• Insurance Verification Process

  Our insurance eligibility verification process includes :-

  • Receive patient schedules from the hospital via fax, email or EDI
  • Verify patient's insurance coverage
  • Contact patients for additional information
  • Update the billing system with eligibility and verification details including member ID, group ID, co-pay information, coverage start and end dates, and so on
• Coding

  Coding is a critical and integral piece of the revenue cycle. And often the most daunting. From ICD-10 to changing payer trends there is a lot to take your focus away from your primary concern – "The Patient"

  • Ensure ICD-10 compliance
  • Reduce AR backlogs
  • Decrease in DNFB (Discharges not fully billed)
  • Improve quality of care
  • Improve provider documentation
  • Reduce turnaround times
  • Enjoy more reliable data reporting

  CHS provides comprehensive medical coding services including:

  • Improve Clinical Documentations: Data quality, completeness and authentication.
  • Comprehensive E&M review to include ICD-9 or ICD-10 diagnoses and CPT Codes and/or HCPCS Level II Provider documentation review for severity of illness and specificity
  • Coding Audits
  • Clear Coding Backlogs
  • Map & Translate Codes
  • Train and test internal coders
  • Coding Denial Management
  • Provider Audit & Education
  • Merit-based Incentive Payment System (MIPS)
  • Medical coding for professional & Facility services
  • Evaluation and management coding
• Charge Entry Services

  A highly trained team of medical billing professionals handle charge entry process as follows :-

  • Charges are entered into the clients medical billing system in accordance with account specific regulations
  • Withheld or pending documents are sent to the client for clarification and on a pre-determined schedule
  • The final charges are thoroughly reviewed by the quality team and clean claims are filed
• Electronic Claim Submission

  We give utmost importance to the privacy and security of patient data and ensure that claims are only transmitted electronically. This reduces processing delays and ensures high readability, thereby assuring that no claims are rejected due to illegibility.

  With electronic claim submission, tracking claims become easier, corrections can be made instantaneously and there won't be any lag in receiving carrier confirmation reports, all of which will go a long way in avoiding costly rejection.

• Payment Posting

  We post all the payments received from patients and insurance companies to the patients' accounts in the clients billing system. Once this is done, the posted payments are balanced against the deposit slips and checks are done for any inaccuracies or underpayment to ensure accuracy in payment.

  Checks and balances are also carried out on electronic posting of payments into the billing software and necessary documents related to EOB (Explanation of Benefits) are stored for future reference.

• Denial Management

  The healthcare environment is changing. The Affordable Care Act and the transition to ICD-10 put an added layer of expense and complexity on our already burdened system. Patient volumes are on the rise with the newly insured, and high-deductible plans are putting added pressure on revenue cycle operations and their drive to collect. The key to success is access to a large pool of qualified denial management resources that work in any Practice Management System and understand how to quickly and correctly analyse account history, appeal denied claims, and get timely turnaround to recover on and close out Accounts Receivable. Analysts adept at trending denials and looking for patterns of deficiency will increase cash flow and reduce aging A/R.

  • CHS provides the access to a large and scalable pool of resources experienced in multiple Practice Management Systems.
  • Complete Range of RCM Outsourcing Services Provided by Expert Revenue CycleManagement Company
  • Our revenue cycle management outsourcing services is geared towards more than 80 specialties, covering the entire healthcare revenue cycle operations—from claim creation, quick submission, aggressive follow-up, denial management, appeals, payment posting and reporting — to help you get paid 30% more, 45% quicker.
• Accounts Receivable Management and Follow Up

  AR management team can address every possible difficulty that can affect cash inflows to your organization. Our goal here is to collect every penny owed to you as quickly as possible and plan to achieve this by accelerating cash flows and reducing the AR days — by streamlining the medical claim submission process, increasing clean-claims rate, carrying out proper root-cause analysis of claim denials and ensuring regular follow-ups with insurance companies as well as patients for outstanding dues and payments.

  Our outsourced Accounts Receivable management and Coding solutions also include the following optional services:
  
  

  • Handling of Refunds
  • Secondary Claims Filing
  • Insurance and Patient Follow-up
  • Handle Appeals for contested claims
  • Generate and mail patient statements
  • Indexing of documents to the patient accounts
  • Prepare Customized management reports
  • Medical Coding Services
  • Offshore coding audits
  • Payer specific coding services
  • Chart Audits and Code Reviews

  The basic components of the revenue cycle are interdependent parts, which work synergistically to enhance the full RCM process. Each component, from eligibility verification, charge coding, claims scrubbing, accounts receivable (AR), and denial management, directly affect the RCM process. For instance, poor verification of insurance eligibility, can lead to services being provided even though the patient is not covered. That will create problems on the back end when a claim is denied and the practice has to collect from the patient.

• Data Analytics

  We understand that data plays a crucial role in plugging the torrent of unpaid claims. Hence we have made data analysis an integral part of our denial management services and ensure that every claim that is being denied by your payers is thoroughly scrutinized. Leveraging this level of intelligence, our denial management specialists can easily spot and fix the issues that are leading to the denials (whether it be issues with the claims or issues with the payers) and stop the stream of unpaid claims into your hospital revenue cycle. Once we do this, you can expect an inflow of additional 20% to 30% of revenues into your healthcare practice.