PHYSICIAN REVENUE CYCLE MANAGEMENT

Expertly designed workflows to improve revenue cycle vital signs

Physicians are passionate about quality healthcare and deserve a partner equally committed to the quality, health and care of their healthcare business. Revenue cycle is more than just a business operation—it complements the care physicians provide.

We recognize patient satisfaction is earned with each interaction—from initial patient engagement to clinical care to when the final bill is paid. Our scheduling, coding and billing services can help improve cash collections, timeliness of payments, denial rates and practice performance metrics.

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CASE STUDY

Multi-specialty physician group with 300 providers

Identify opportunities, align on metrics and goals, track impact and measure performance with Conifer’s Physician Revenue Cycle Management solutions

How We Helped:
  • Assessed existing people, processes and technology to analyze gaps and drive performance improvement
  • Developed roadmap for hybrid technology model allowing for advanced analytics and actionable insights
  • Implemented quality reporting program to address 17 new NCQA HEDIS® quality measures, earning an additional $225k incentive in a single performance year

77%

increase in average monthly collection

77%

increase in average monthly collection

25%

decrease in A/R days

80%

reduction in coding turnaround time

80%

reduction in coding turnaround time

Integrate Seamlessly. Prioritize Patient Experience. Maximize Margins.

Our Physician Revenue Cycle Management solutions balance completeness, correctness and promptness of payment with a drive to deliver an exceptional patient experience. We engineered our delivery model to support your revenue cycle end-to-end or any point in between, powered by proven methodologies, repeatable processes, flexible technologies and measurable performance.

Focus on front-end performance to prevent downstream challenges

Conifer Health’s Patient Access & Experience solutions provide scheduling, pre-registration, registration and eligibility confirmation services purpose-built for patient satisfaction.

Our solution includes:
  • Registration assistance for capturing accurate demographics and insurance information
  • Appointment scheduling for patient convenience
  • Verification of benefits for precise claims submission
  • Service authorization confirmation and status tracking
  • PCI-Compliant payment processing
  • Digital patient engagement technology integrated with a Best in KLAS partner
Key benefits:
  • Improve data integrity for first-time, clean claim submission
  • Collect co-payments and other patient responsibility due at time of service
  • Engage patients digitally, in-person and over-the-phone with friendly, informative communications

Key Benefits are results from past engagements and not a guarantee of future performance.

Specialty-specific coders and physician-support tools drive impact

Conifer Health’s Coding & Documentation solutions deploy a comprehensive suite of capabilities for coding, coding quality, clinical documentation improvement and compliance—offering opportunities to improve accuracy, decrease denials and increase productivity.

Our solution includes:
  • Expertise across settings and specialties, including those with complex coding requirements
  • Audit and analysis to support accurate code assignment and compliance risk identification
  • Physician-tailored, peer-to-peer education on medical specificity standard
  • Physician-centric E&M documentation query process for accurate reimbursement and quality of care reporting
  • EMR-embedded clinical documentation improvement tools
  • Staff skilled by medical specialty with certifications from organizations such as the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA)
Key benefits:
  • Ensure accurate, comprehensive coding
  • Reduce initial and final denial rates
  • Improve 9-month denial resolution rates
  • Reduce coding turnaround time

Key Benefits are results from past engagements and not a guarantee of future performance.

Increase cash and net collections with insightful business support

Conifer Health’s Billing & Collections solutions for claims submission, cash posting, third-party resolution and denials management introduce process flows crafted to increase the speed of payment without compromising your ability to collect every dollar earned.

Our solution includes:
  • Multi-site, global delivery model that mitigates operational risk and supports instantaneous velocity regardless of volume
  • Intelligent process automation informed by continuous improvement feedback loops
  • Predictive analytics to identify payer behavior in denials and claims adjudication
  • Scalable and specialized staff with claim-specific skill sets
  • Denials prevention program with dedicated teams, deep payer knowledge and policy expertise
  • Patient Advocates to resolve billing inquiries
Key benefits:
  • Increase average monthly collections
  • Decrease A/R days and other A/R aging metrics
  • Reduce no response A/R > 90 days
  • Reduce credit balances

Key Benefits are results from past engagements and not a guarantee of future performance.

Focus on front-end performance to prevent downstream challenges

Conifer Health’s Patient Access & Experience solutions provide scheduling, eligibility confirmation, pre-registration and registration services purpose-built for patient satisfaction.

Our solution includes:
  • Registration assistance for capturing accurate demographics and insurance information
  • Appointment scheduling for patient convenience
  • Verification of benefits for precise claims submission
  • Service authorization confirmation and status tracking
  • PCI-Compliant payment processing
  • Digital patient engagement technology integrated with a Best in KLAS partner
Key benefits:
  • Improve data integrity for first-time, clean claim submission
  • Collect co-payments and other patient responsibility due at time of service
  • Engage patients digitally, in-person and over-the-phone with friendly, informative communications

Key Benefits are results from past engagements and not a guarantee of future performance.

Specialty-specific coders and physician-support tools drive impact

Conifer Health’s Coding & Documentation solutions deploy a comprehensive suite of capabilities for coding, coding quality, clinical documentation improvement and compliance—offering opportunities to improve accuracy, decrease denials and increase productivity.

Our solution includes:
  • Expertise across settings and specialties, including those with complex coding requirements
  • Audit and analysis to support accurate code assignment and compliance risk identification
  • Physician-tailored, peer-to-peer education on medical specificity standard
  • Physician-centric E&M documentation query process for accurate reimbursement and quality of care reporting
  • EMR-embedded clinical documentation improvement tools
  • Staff skilled by medical specialty with certifications from organizations such as the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA)
Key benefits:
  • Ensure accurate, comprehensive coding
  • Reduce initial and final denial rates
  • Improve 9-month denial resolution rates
  • Reduce coding turnaround time

Key Benefits are results from past engagements and not a guarantee of future performance.

Increase cash and net collections with insightful business support

Conifer Health’s Billing & Collections solutions for claims submission, cash posting, third-party resolution and denials management introduce process flows crafted to increase the speed of payment without compromising your ability to collect every dollar earned.

Our solution includes:
  • Multi-site, global delivery model that mitigates operational risk and supports instantaneous velocity regardless of volume
  • Intelligent process automation informed by continuous improvement feedback loops
  • Predictive analytics to identify payer behavior in denials and claims adjudication
  • Scalable and specialized staff with claim-specific skill sets
  • Denials prevention program with dedicated teams, deep payer knowledge and policy expertise
  • Patient Advocates to resolve billing inquiries
Key benefits:
  • Increase average monthly collections
  • Decrease A/R days and other A/R aging metrics
  • Reduce no response A/R > 90 days
  • Reduce credit balances

Key Benefits are results from past engagements and not a guarantee of future performance.

PERFORMANCE PROFILE

Not-for-profit faculty group practice comprised of 1,200+ primary and specialty care physicians across 140 locations

96%

NET COLLECTION RATE

~6%

INITIAL DENIAL RATE

29

A/R DAYS

21%

A/R > 90 DAYS

“Over the many years of our relationship, Conifer continuously demonstrates its expertise as a service provider and its support as a strategic partner. The team has proven its value to our strong performance time and time again through their extensive revenue cycle knowledge, insightful analytics and innovative leadership.”

Senior Vice President
Physician Revenue Cycle

PERFORMANCE PROFILE

Not-for-profit faculty group practice comprised of 1,200+ primary and specialty care physicians across 140 locations

96%

NET COLLECTION RATE

~6%

INITIAL DENIAL RATE

29

A/R DAYS

21%

A/R > 90 DAYS

“Over the many years of our relationship, Conifer continuously demonstrates its expertise as a service provider and its support as a strategic partner. The team has proven its value to our strong performance time and time again through their extensive revenue cycle knowledge, insightful analytics and innovative leadership.”

Senior Vice President
Physician Revenue Cycle

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