This tool provides an analysis of the basic 5 (B5) data elements that drive revenue cycle metrics and indicators (gross charges, adjustments, collections, accounts receivables and total RVUs) to identify potential performance gaps and opportunities.
The Revenue Pathway assesses the complete revenue cycle beginning with data capture for patient demographics, all the way through denial management and dealing with bad debt. The assessment is designed to provide managers with a clear view of uses for available reports and the use of that information in properly managing billing and collecting activities.
Equation will provide interim management of the revenue cycle in the absence of a full time staff and/or will provide implementation of improvement and corrective actions identified during the assessment period.
Recognizing charge capture and billing nuances specific to the RHC revenue cycle, Equation incorporates the Center for Medicare and Medicaid Services (CMS) regulatory criteria into the Revenue Pathway.
Payer Portal provides a detailed view of whether payers are reimbursing hospitals and practice groups according to agreed upon managed care contracts. It conducts analysis at the CPT level to understand the expected and actual reimbursement, and the causes of any disparity.
Collecting various data sets, Rates Pathway leverages proprietary data-driven methodologies to do “on-the-fly” analysis of proposed rates, and how those rates financially impact the practice. This powerful tool helps determine the ideal rate and guides providers through the negotiation process.
