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RevCycle+™
The next generation of coding and billing
• Dallas, TX
• HQ, clinical content
and R&D COE
• Williamsburg, VA
• East physician
revenue cycle COE
• Kansas City, MO
• Facility coding COE
• Cerritos, CA
• West physician
revenue cycle
COE
• 39M+ patients each year
• Clinical, workflow and revenue
cycle solutions
T-System is everywhere emergency medicine is practiced.
Solutions For Entire ED Care Process
3
Notification,
handoff and
chart access
PCP referrals,
care plans and
patient transition management
PDI, eRx
follow-up
Utilization
review
Professional,
facility, CPT,
observation, ICD
POS collections, charge
capture, billing, denials,
collections
Patient access,
Published wait times,
pre-notification
Tracking, triage,
charting, orders,
admit, transfer,
optimization
4
• Little automation
• Slower processing
• Accuracy relies on skill of
the individual coder or biller
• Limited performance
transparency
• Lack of education to
providers
Today, outsourced services are often performed
as they would have been 20 years ago.
5
On average, EDs are only collecting 27% of
charges and patient responsibility and self pay
patients are increasing.
Identity &
Insurance
Verification
Pre-
registration
Registration
Charge
Capture
Check-Out Coding
Claims
Processing
Post
Service
Payments
Collections
Patient access Billing & collections
Collections
Percentage of Covered Workers Enrolled in a High-Deductible Plan
Note: These estimates include workers enrolled in HDHP/SO and other plan types. Because we do not collect information on the attributes of
conventional plans, to be conservative, we assumed that workers in conventional plans do not have a deductible of $1,000 or more. Because of
the low enrollment in conventional plans, the impact of this assumption is minimal. Average general annual health plan deductibles for PPOs,
POS plans, and HDHP/SOs are for in-network services.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2006-2011.
High-deductible plans are on the rise – estimated
70% of US employers in 2013.
T-System is Transforming the Process
Automating manual
process for improved
efficiency and fewer
errors
Real-time performance
visibility to identify
areas of potential
improvement
Client service expertise
such as ongoing
provider training, payer
contract negotiation
and credentialing
7
RevCycle+™
| RevCycle+™
8
Electronic eligibility
verification;
claims, denial, aging and
collections management;
A/R
Advanced coding with
medical decision
making calculator
POS collection
Patient responsibility & collections optimization, credentialing,
contract management, documentation training, compliance
+ Expert client services
+ Real-time visibility
+ Advanced technology
T-System clients increase collections by $10-30 per patient visit
$500,000 to $1.5 million per year.
Advancing the Coding Process with
Technology
9
Audit report
Details how a level of service
was calculated
• Decrease the subjectivity
of code choice
• Create a defensible audit
report
Want to know how many
charts had no social history?
RC+ can report by
provider, by date, or other
criteria
Reportable data
MDM calculation
• CT, lab, MRI, and more
• Utilization data by
provider
Ongoing Q/A
• Clinically trained coders
maintain consistency &
accuracy
Regulatory changes, ICD-10
expertise, payer guidelines
Bringing Collections Management
Sophistication to the ED
10
Predict patient
propensity to pay
based on historical,
local data
Tailor resources and
communication to
maximize collections
Estimate & collect
patient payment up front
1) 2) 3)
• Customize payment options
• Calculate real-time eligibility,
copay & deductible
• Capture patient satisfaction
• iPad enabled
• Define patient communication
plans, timing & methods
• Improve patient engagement
through specific activities
• Reduce risk of inappropriate
collection activity
Providing Real-time Performance
Visibility
11
• Real-time data
• Easy-to-use web interface
• Drill
down, decomposition, and
more for analysis at all
levels of data
• Standard reporting pack
• Security features to specify
access by log-in
Delivering an Expert Level of Service
• Performance monitoring and proactive
identification of issues
• Ongoing physician training including ICD-10
training for providers, scribes, mid-levels
• Legal/compliance support
• Credentialing
• Contract negotiation
• Regulatory change monitoring
12
T-System knows the
ED – and provides
service beyond just
coding & billing
30+ years of experience
in clinical, revenue cycle
and operational ED
management
info@tsystem.com
(972) 503-8899
Contact us today for a free assessment.

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T-System's RevCycle+, the next generation of ED coding & billing.

  • 1. RevCycle+™ The next generation of coding and billing
  • 2. • Dallas, TX • HQ, clinical content and R&D COE • Williamsburg, VA • East physician revenue cycle COE • Kansas City, MO • Facility coding COE • Cerritos, CA • West physician revenue cycle COE • 39M+ patients each year • Clinical, workflow and revenue cycle solutions T-System is everywhere emergency medicine is practiced.
  • 3. Solutions For Entire ED Care Process 3 Notification, handoff and chart access PCP referrals, care plans and patient transition management PDI, eRx follow-up Utilization review Professional, facility, CPT, observation, ICD POS collections, charge capture, billing, denials, collections Patient access, Published wait times, pre-notification Tracking, triage, charting, orders, admit, transfer, optimization
  • 4. 4 • Little automation • Slower processing • Accuracy relies on skill of the individual coder or biller • Limited performance transparency • Lack of education to providers Today, outsourced services are often performed as they would have been 20 years ago.
  • 5. 5 On average, EDs are only collecting 27% of charges and patient responsibility and self pay patients are increasing. Identity & Insurance Verification Pre- registration Registration Charge Capture Check-Out Coding Claims Processing Post Service Payments Collections Patient access Billing & collections Collections
  • 6. Percentage of Covered Workers Enrolled in a High-Deductible Plan Note: These estimates include workers enrolled in HDHP/SO and other plan types. Because we do not collect information on the attributes of conventional plans, to be conservative, we assumed that workers in conventional plans do not have a deductible of $1,000 or more. Because of the low enrollment in conventional plans, the impact of this assumption is minimal. Average general annual health plan deductibles for PPOs, POS plans, and HDHP/SOs are for in-network services. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2006-2011. High-deductible plans are on the rise – estimated 70% of US employers in 2013.
  • 7. T-System is Transforming the Process Automating manual process for improved efficiency and fewer errors Real-time performance visibility to identify areas of potential improvement Client service expertise such as ongoing provider training, payer contract negotiation and credentialing 7 RevCycle+™
  • 8. | RevCycle+™ 8 Electronic eligibility verification; claims, denial, aging and collections management; A/R Advanced coding with medical decision making calculator POS collection Patient responsibility & collections optimization, credentialing, contract management, documentation training, compliance + Expert client services + Real-time visibility + Advanced technology T-System clients increase collections by $10-30 per patient visit $500,000 to $1.5 million per year.
  • 9. Advancing the Coding Process with Technology 9 Audit report Details how a level of service was calculated • Decrease the subjectivity of code choice • Create a defensible audit report Want to know how many charts had no social history? RC+ can report by provider, by date, or other criteria Reportable data MDM calculation • CT, lab, MRI, and more • Utilization data by provider Ongoing Q/A • Clinically trained coders maintain consistency & accuracy Regulatory changes, ICD-10 expertise, payer guidelines
  • 10. Bringing Collections Management Sophistication to the ED 10 Predict patient propensity to pay based on historical, local data Tailor resources and communication to maximize collections Estimate & collect patient payment up front 1) 2) 3) • Customize payment options • Calculate real-time eligibility, copay & deductible • Capture patient satisfaction • iPad enabled • Define patient communication plans, timing & methods • Improve patient engagement through specific activities • Reduce risk of inappropriate collection activity
  • 11. Providing Real-time Performance Visibility 11 • Real-time data • Easy-to-use web interface • Drill down, decomposition, and more for analysis at all levels of data • Standard reporting pack • Security features to specify access by log-in
  • 12. Delivering an Expert Level of Service • Performance monitoring and proactive identification of issues • Ongoing physician training including ICD-10 training for providers, scribes, mid-levels • Legal/compliance support • Credentialing • Contract negotiation • Regulatory change monitoring 12 T-System knows the ED – and provides service beyond just coding & billing 30+ years of experience in clinical, revenue cycle and operational ED management
  • 13. info@tsystem.com (972) 503-8899 Contact us today for a free assessment.

Notes de l'éditeur

  1. Today over 1900 hospital based EDs reply on our paper or electronic documentation solutions to drive their EDThis large customer base gives us thousands of feedback every year which allows us to keep our content up to date and continuously refreshed with best practices.We serve our customers out of 4 offices… Dallas is our corporate office and where we do all of the R&D work. Our Revenue Cycle customers are supported out of regional offices on the west coast, east coast, and Kansas City
  2. That’s who we are as a company and we are focused on being the best we can be in emergency medicine, or what we call as “unscheduled care”Our strategy is to provide a complete closed loop solution for unscheduled care-- from the point where the patient at home is not feeling well and decides they need care, to the point where they either return home or are transferred to some other care giver, to where the providers and hospitals get paid, and all the handoffs and processes in between.Today we have products and services that cover the entire emergency care process…