Revenue Cycle Management
Oracle's home health and hospice revenue cycle management services are designed to expedite internal processes, improve payor response time, and enhance cash flow
The revenue cycle encompasses the entire journey from appointment scheduling to claim submission and payment receipt. While it may seem straightforward, there are critical steps that, if not executed correctly, can lead to delayed payments, reduced revenue, and added stress for your agency.
Drawing on more than 30 years of industry-leading practices, scalable resources, and advanced technology, Oracle’s dedicated team of revenue cycle experts in home health and hospice bring extensive billing expertise and assurance to your agency’s revenue cycle. We conduct a thorough analysis of your processes, identify areas where reimbursement may be lacking, and implement optimizations to expedite cash flow and maximize your financial well-being.
Oracle’s Revenue Cycle Management Solutions:
Insurance Eligibility
The revenue cycle initiates at the point of patient intake, and the information gathered or verified during this process plays a vital role in ensuring effective claim resolution and optimizing revenue cycle operations.
Eligibility verification encompasses several essential aspects, including:
- Validating the current coverage status of the patient.
- Determining any specific service authorization requirements.
- Understanding the reimbursement methodology of the payor.
- Identifying the patient's responsibility for upfront collection.
Service/Payor Pre-Authorization
Obtaining authorization or pre-certification for services plays a crucial role in the payor approval process, which directly impacts reimbursement. It involves not only determining which services require notification and approval but also tackling the more challenging task of securing the authorization itself.
Oracle specializes in managing a wide range of client activities and performs authorization procedures within various EMR environments, catering to all payors.
Our services encompass:
- Assisting with the completion and submission of the necessary initial paperwork for authorization.
- Conducting diligent follow-up for recertification or re-authorization of additional or add-on services.
Billing and Claims Management
Oracle empowers your organization to enhance revenue acceleration through sophisticated technology-driven claim resolution. Our services assist you in eliminating labor-intensive billing processes, expediting claims submissions, and optimizing cash flow, allowing you to concentrate on providing excellent patient care.
Key areas we address include:
- Timely notification of admission (NOA) to ensure swift initiation of the billing process.
- Notice of election (NOE) processing to meet regulatory requirements.
- Streamlined claims submission and resolution of any edit-related issues.
- Proactive measures to mitigate any delays in claim follow-up, ensuring prompt reimbursement.
