We find the money you have been missing.

We get you paid on earned, but unrealized, revenue using our proven discovery process. We don’t need a month to ramp up, you do not need to capitalize new hardware or software and we definitely don’t need to disrupt your overburdened staff.. we can give you legitimate and actionable answers on our very first day.

How?

Our team of hospital administrators, physicians, clinical experts and software and database developers invested heavily over the last 10 years developing proprietary databases, algorithms, analytics and relational database analysis to identify missed revenue opportunities, documentation errors, data inadequacies and process mistakes that adversely affect financial performance of a healthcare organization. Our clients get “real time” analytics and informatics into their billing, collections, denials and staff productivity issues across the entire revenue cycle.

We aggregate disparate patient clinical and accounting data, payer remittances, collector workstation activity, and third-party information to proactively identify trends, bottlenecks and black hole accounts. Using a proprietary business rules engine, we enable business office staff to intelligently prioritize account follow-up activities and standardize best-practice workflows to maximize net revenue and cash acceleration. The solution also provides a collaborative platform for enterprise revenue cycle reporting and analysis, empowering both executives and analysts to monitor revenue cycle trends, benchmark performance across the organization, and drill down to the root causes of outliers and variances.

Get “actionable” information that allows you to..
• Gain insight into solving your facility’s remittance and claim challenges
• Report on every financial detail of a claim or EOB
• Utilize latest rules engine prior to or post claim submission
• Present your data in visual, interactive charts and graphs
• Improve efficiency and productivity with administrative reporting
• Create custom ad hoc reports to fit your facility’s needs
• See Dashboards and schedule reports for automatic email delivery
• Reduce overhead on the cost of processing each claim
• Increase revenue and accelerate cash flow
• Increase AR, improve balance sheet and P&L

Revenue Cycle Analytics – Performance Improvement.

Information technology meets business intelligence in our Revenue Cycle Optimization solution. Discover new opportunities to improve financial performance as we will help you:

• Improve Financial Performance
• Reduce Financial and Clinical Risk
• Improving Access Management
• Reduce Administrative Inefficiencies
• Gain improved control over Accounts Receivable
• Enhance Cash Collection
• Enhance Patient and Provider Satisfaction
• Improve Payer Performance

“Our Pledge” – Understanding the Problem

With the healthcare industry in the midst of an unprecedented time of change requiring healthcare providers to analyze and evaluate every aspect of their business. These changes have brought a financial dilemma and burden that could impact a provider’s ability to retain profitability, operational control and effective administration during this era. There has been incredible effort placed on improving operational efficiency and running a lean organization while maintaining the highest level of patient satisfaction. Many organizations have made tremendous improvements prior to service and at point of service entry points all in an effort to increase cash collections along with an improved patient experience. Independent tools such as insurance verification, claims scrubbing, coding and reimbursement solutions, clinical decision support, healthcare predictor scoring, and other analytical tools have been employed to minimize any lost opportunity for recovery but still fall short of desired expectations.

In spite of these revenue cycle initiatives, the fact remains that nationwide, CMS and AHA state that up to 44% of hospital revenue is unrealized, due to claims being unbilled or under billed. Complete rejections by payer vary from 2.68% (UHC) to almost 7% (Medicare whose was 1.7 times higher than commercial payers).

Our Revenue Cycle Analytics provides healthcare provider organizations with “real time” and historical insight into billing, collections, denials and staff productivity across the entire revenue cycle. We aggregate disparate patient accounting data, payer remittances, collector workstation activity, and third-party information to proactively identify trends, bottlenecks and black hole accounts. Using a proprietary business rules engine which enables business office staff to intelligently prioritize account follow-up activities and standardize best-practice workflows to maximize net revenue and cash acceleration. The solution also provides a collaborative platform for enterprise revenue cycle reporting and analysis, empowering both executives and analysts to monitor revenue cycle trends, benchmark performance across the organization, and drill down to the root causes of outliers and variances.

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CONTACT

PARADIGM HEALTHCARE STRATEGIES

9911 Rose Commons Drive
Huntersville, NC 28078
(855) 872-2744

ABOUT

Our mission is to provide independent physicians with the means to remain independent. Our extensive network of healthcare consultants, hospital administrators, physicians, clinical experts and software developers have the expertise needed to diversify your practice’s revenue streams and process management, while maximizing patient care.