REVENUE MANAGEMENT

Increase cash collections and optimize yield

With increased complexity of payor contracts and escalating volumes of small balance claims, maximizing cash collections for A/R inventory is challenging for many health systems and physician groups.  

We can help maneuver through the intricate payor processes and deliver improved net revenue and yield performance. Whether you need a one-time clean-up project or a comprehensive revenue management operation, we can meet your need.  

Let’s Talk

CASE STUDY

Academic Health System — 2 Hospitals, School of Medicine

Transform and optimize revenue cycle processes with Conifer’s Revenue Management solutions

“Conifer has been an unbelievably understanding and cooperative partner during our transformation. They have dedicated enormous resources toward the health system that has continued greatly to our successes.”

Health System
Chief Financial Officer

$130M

PER YEAR IN ADDITIONAL CASH COLLECTIONS

$130M

PER YEAR IN ADDITIONAL CASH COLLECTIONS

41%

REDUCTION IN A/R DAYS

41%

REDUCTION IN A/R DAYS

Improve Patient Experience. Minimize Future Denials. Increase Cash Collections.

Our Revenue Management solutions optimize speed and completeness of payment. Whether you are needing cleaner claims submission to reduce denials, deeper payor payment and process understanding, or patient-centric self pay avenues, we can help deliver a stronger bottom line.

Ensure clean claims and compliant billing

Conifer Health’s Claims Submission solution takes a consultative approach that is focused on improving cash collections and account resolution through deep payer analysis and identifying trends that may present hidden recovery opportunities.

Our solution includes:
  • Pre-bill holds and Clearinghouse edit management
  • Automated workflows and electronic claims submission
  • Proprietary regulatory requirements compliance process
  • CMS, Medicare and Medicaid compliant billing
Key benefits:
  • Claim profiling that predicts propensity to pay and drives appropriate follow-up
  • Centralized hub of specialists that resolves claim errors
  • <0.5% write-offs from claim denials
  • Daily reporting and monthly scorecards measure performance measurement
Outcomes:
  • >90% Clean Claims Rate
  • 64% Reduction in Claim Correction Turn-Around Time
  • 76% First Pass Payment Rate
Achieve full reimbursement and reduce time-to-cash

Conifer Health’s Third-Party Resolution solution leverages automation and technology to efficiently and effectively accelerate providers access to earned revenue.

Our solution includes:
  • Automated claims status, appeals, remittance process and expedited follow-up processes
  • Predictive modeling to maximize cash collection and reduce aging
  • Flexible business model – targeted to full inventory
  • Payor behavior analytics, trending and payment variance identification
Key benefits:
  • 33% Decrease in A/R cycle time
  • Payor behavior analytics and trending
  • More than 250 payors on direct connect
  • Dedicated clinicians for appeals and audits
Outcomes:
  • 98% clean first pass claim rate
  • 20% improvement in aged A/R >90 days
  • 8-12% increase in small balance collections
Preserve revenue and prevent future denials

Conifer Health’s Denials Management solution gives providers the power to recoup revenue lost through inappropriate clinical, technical and administrative denials – capture full reimbursement.

Our solution includes:
  • Clinical Denial Prevention, Review and Appeal
  • Clinical and Technical Underpayment Review and Appeal
  • Government Audit Review and Appeal
  • Automated workflows, worklists and predictive modeling to expedite cash collections
  • Trending of account metrics, performance and payer behavior
Key benefits:
  • Data-driven insights for denials reduction with continuous feedback loop
  • Root-Cause Analysis tool to allow creation of specific action plans to prevent denials
  • Improved payor insights using payor scorecards and benchmarking
  • Expedited response to denials through a combination of automated and smart text appeals
Outcomes:
  • 22% Decrease in Overall Denials
  • 133K+ automated first-level technical appeals
  • 35% Recovery Rate from Pre-Demand Payor Escalations
Improve cash flow and resolve outstanding A/R inventory

Conifer Health’s Self-Pay and Balance After Insurance (BAI) Collections solution provides a compliant, patient-first approach to capturing revenue and providing exceptional customer service.

Our solution includes:
  • Robust contact center operations and multi-channel communications
  • Flexible payment model – self-service and full-service
  • Defined patient escalation and account handling
  • Propensity-to-pay modeling
Key benefits:
  • Ongoing regulatory and compliance reviews of patient communications
  • MicroSegmentation® and machine learning technologies create effective and efficient processes
  • 40% self-service adoption
  • Expertise in 501(r) compliance
Outcomes:
  • 7% decrease in bad debt assignment
  • 12% lower payment plan default rates
  • 11% Increase in payment plan adoption
Ensure clean claims and compliant billing

Conifer Health’s Claims Submission solution takes a consultative approach that is focused on improving cash collections and account resolution through deep payer analysis and identifying trends that may present hidden recovery opportunities.

Our solution includes:
  • Pre-bill holds and Clearinghouse edit management
  • Automated workflows and electronic claims submission
  • Proprietary regulatory requirements compliance process
  • CMS, Medicare and Medicaid compliant billing
Key benefits:
  • Claim profiling that predicts propensity to pay and drives appropriate follow-up
  • Centralized hub of specialists that resolves claim errors
  • <0.5% write-offs from claim denials
  • Daily reporting and monthly scorecards measure performance measurement
Outcomes:
  • >90% Clean Claims Rate
  • 64% Reduction in Claim Correction Turn-Around Time
  • 76% First Pass Payment Rate
Achieve full reimbursement and reduce time-to-cash

Conifer Health’s Third-Party Resolution solution leverages automation and technology to efficiently and effectively accelerate providers access to earned revenue.

Our solution includes:
  • Automated claims status, appeals, remittance process and expedited follow-up processes
  • Predictive modeling to maximize cash collection and reduce aging
  • Flexible business model – targeted to full inventory
  • Payor behavior analytics, trending and payment variance identification
Key benefits:
  • 33% Decrease in A/R cycle time
  • Payor behavior analytics and trending
  • More than 250 payors on direct connect
  • Dedicated clinicians for appeals and audits
Outcomes:
  • 98% clean first pass claim rate
  • 20% improvement in aged A/R >90 days
  • 8-12% increase in small balance collections
Preserve revenue and prevent future denials

Conifer Health’s Denials Management solution gives providers the power to recoup revenue lost through inappropriate clinical, technical and administrative denials – capture full reimbursement.

Our solution includes:
  • Clinical Denial Prevention, Review and Appeal
  • Clinical and Technical Underpayment Review and Appeal
  • Government Audit Review and Appeal
  • Automated workflows, worklists and predictive modeling to expedite cash collections
  • Trending of account metrics, performance and payer behavior
Key benefits:
  • Data-driven insights for denials reduction with continuous feedback loop
  • Root-Cause Analysis tool to allow creation of specific action plans to prevent denials
  • Improved payor insights using payor scorecards and benchmarking
  • Expedited response to denials through a combination of automated and smart text appeals
Outcomes:
  • 22% Decrease in Overall Denials
  • 133K+ automated first-level technical appeals
  • 35% Recovery Rate from Pre-Demand Payor Escalations
Improve cash flow and resolve outstanding A/R inventory

Conifer Health’s Self-Pay and Balance After Insurance (BAI) Collections solution provides a compliant, patient-first approach to capturing revenue and providing exceptional customer service.

Our solution includes:
  • Robust contact center operations and multi-channel communications
  • Flexible payment model – self-service and full-service
  • Defined patient escalation and account handling
  • Propensity-to-pay modeling
Key benefits:
  • Ongoing regulatory and compliance reviews of patient communications
  • MicroSegmentation® and machine learning technologies create effective and efficient processes
  • 40% self-service adoption
  • Expertise in 501(r) compliance
Outcomes:
  • 7% decrease in bad debt assignment
  • 12% lower payment plan default rates
  • 11% Increase in payment plan adoption

Industry Insights and Perspectives

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