Global Revenue Cycle Services - Signature Performance
Global Revenue Cycle Services
Signature can help you meet your reimbursement, compliance, data quality and staffing goals through our suite of services from Patient Appointing to Denial Management, with expertise at every step along the way. We specialize in off-site medical billing, collection and follow-up, as well as staffing and program management for medical support services.
In addition to standard service contracts, we have developed an On-Site Revenue Cycle Performance Assessment to identify opportunities for improvement and enhance operational efficiency at your facility. Through our years of experience and subject matter expertise in all facets of the revenue cycle, our team can uncover issues that otherwise go unnoticed. As proficient back-end output relies heavily on front-end actions, this solution is designed to link people and process across the entire revenue cycle.
Phase 1: Pre-Assessment
As the first step, our team, in conjunction with the facility leadership, will perform a pre-assessment to understand the specific needs of the facility and identify the areas of focus.
Phase 2: On-Site Assessment Visit
During phase 2, Signature’s team of revenue cycle experts will conduct the in-depth on-site assessment from all angles of day-to-day operations to identify gaps and collect data. We will utilize our comprehensive evaluation tailored for the type of facility.
Phase 3: Analysis and Action Plan
Once the on-site assessment is completed, our team will analyze the findings and develop a detailed action plan with recommendations and strategies aligned with your facility’s specific goals.
Phase 4: On-going Services and Support
As services and process improvements are implemented, your facility will continue to have access to Signature’s team of experts for any day-to-day on-going support.
Gather and update patient medical, demographic and insurance information into the client system.
Other Health Insurance (OHI) Discovery
Identify and capture other health insurance through:
Signature Insurance Network Databases
Personal Interviews with Beneficiaries
Collection of Beneficiaries Insurance Card(s)
DD Form 2569 Letter Campaigns
Promote and educate beneficiaries on the impact and importance of OHI discovery
Insurance Verification and Authorization
Utilize Signature's Electronic OHI Network to obtain other health insurance plan coverage information.
Information is updated to ensure the health care facility has highly accurate and complete patient insurance.
Improves patient and payer relations and velocity of collections while reducing rejected claim volume.
Patient other health insurance information is validated through:
Insurance ID cards
Coordinate appointments with other direct-care providers.
Match patient and provider based on the appropriate Access to Care (ATC) category and detail codes.
Transcribe highly specialized and accredited medical dictation, meeting medical, legal, and organizational requirements.
Coding and Coding Auditing
Review and assign appropriate ICD-9, CM and CPT/HCPCS codes within client systems
Ensure multiple CPT codes not components of a larger, more comprehensive procedure.
Assign modifiers as appropriate within client specific coding guidelines.
Audit clinical encounter documentation prior to billing.
Provide audit outcomes to appropriate personnel for required actions.
Generate (electronically and manually) Inpatient, Clinical, Laboratory, Radiology, Pharmacy, Ambulance and other ancillary service claims for submission to patients' insurance benefit plans.
Review Explanation of Benefit (EOB) from other health insurance payers to ensure proper reimbursement based on the beneficiary's insurance benefit plan and the 32 CFR.
Manage outcomes of EOB audits through our Accounts Receivable team to determine appropriate follow up activities.
Post and reconcile payments from remittance transactions and/or Explanation of Benefit (EOB) received from insurance benefit plans.
Post approved write offs (i.e. deductibles, co-pays) to the patient account.
Transactions are performed in the appropriate client systems.
Establish key insurance payer relationships to improve cash collections performance, shorten revenue cycle time, improve claims processing, administration, and reimbursements.
Denial Management and Appeals
Establish client-customized claims denial and appeal policies, based on insurance benefit plans and regulatory requirements to reduce future denied claims and optimize recoveries.