Background
Health Care Professional Consulting Services (HCPCS), a consulting group focused on helping post-acute organizations improve their financial operations, supports clients in capturing reimbursement through better processes.
As President and Chief Executive Officer, Julie Ann Kemman, puts it, “A big piece of what we do is chase down the dollars that clients think are gone. We help them fight for the good care that they’ve provided.” Inovalon’s cloud-based revenue cycle management solutions support HCPCS in their mission by offering clarity, efficiency, and empowerment to their clients at every step of the revenue cycle.
“A big piece of what we do is chase down the dollars that clients think are gone. We help them fight for the good care that they’ve provided.””
Julie Ann Kemman, President and Chief Executive OfficerHealth Care Professional Consulting Services
Improving Front-End Verifications
The success of claims payment starts with a strong intake process. Having correct eligibility is absolutely critical, but not always easy. Patients may forget if their coverage has changed or not have their insurance information with them. In hospitals, effective dates may have passed for admissions or readmissions, and in skilled nursing facilities, long-term care policies can impact resident coverage.
For HCPCS’s clients, patient intake is much smoother thanks to Inovalon’s Eligibility Verification Standard™. Kemman shares, “The software is great for intakes and referrals across the whole provider spectrum. Intake departments are really able to look at the benefits available for a patient or resident in real time.”
This software eases the burden of admissions and intake staff, allowing them to focus on getting their patients the care they need. Meanwhile, one quick eligibility search delivers the coverage information their revenue cycle needs, even with just a Social Security number or a name and date of birth to initiate a coverage search.
Streamlining Claims Management
Once care is delivered, Inovalon’s Claims Management Pro™ supports HCPCS clients in creating, submitting, tracking, and correcting all claims for all payers – in one place. The software
simplifies the claims management process from start to finish.
For Kemman, it’s the built-in dashboards that really set the solution apart. She says, “Having the dashboards gives our clients an overarching view of all claims going out, and events tracking lets them see the lifecycle of every claim – where it hit, when it actually came into the system, when it was released to the payer, and when it was acknowledged.”
This level of visibility contributes significantly to the success of clients’ claims, and when claims do need corrections, Claims Management Pro offers easy-to-understand correction guidance to help get claims back out the door quickly. Using this software, HCPCS clients have been able to reduce full-time employee hours spent on claims management by automating some of the process and streamlining the pieces that require a biller’s attention.
“To be able to do appeals right through the
Julie Ann Kemman, President and Chief Executive OfficerHealth Care Professional Consulting Services
Inovalon ONE® Platform cuts down on paper,
timely filing, and mailing fees. There’s a lot to
be said for replacing that manual process.”
End-to-End RCM Success, Driven by Data and Automation
HCPCS helps clients at every step of their revenue cycle, and Inovalon empowers them to do so efficiently. This means less manual work and better results across claims, quality, and care.
“Inovalon is right in sync with where providers need to be to position themselves for the future – with payer relationships, with making sure that they’re collecting all of their money, and with utilizing the data available to them.
In many cases, I require that clients have Inovalon because I know I can manage their services much more efficiently than if they were still doing things the way they always have.””
Julie Ann Kemman, President and Chief Executive OfficerHealth Care Professional Consulting Services
Discover the Power of End-to-End Revenue Cycle Software
Whether you help providers with their billing needs or are a provider looking for better tools to manage your claims, we’re here to help.
