Optimize hospital and physician billing with Epic Resolute
HealthBPM can help you improve your payer contract management by fully using the functionality within Epic’s Resolute module for both physician and hospital billing. By taking this important step, you will more effectively manage your:
- Denial and over-payment work queues
- Expected payment revenue estimators at point of claim
- Payer contract modeling and negotiations
- Patient estimation accuracy
- Claims reserve requirements
- Dashboards and reporting
Recover revenue: 5X return on investment
HealthBPM’s team of experienced Epic Resolute consultants have uncovered unpaid claims and identified underpaid claims in the millions of dollars for our clients. On average, the additional revenue generated from working with HealthBPM has been five times greater than the cost of bringing in our team of experts. In addition to increased revenue, you can reduce or eliminate the additional expense of using a third party contract management system.
Stronger leverage during payer contract negotiations
Having your contracts accurately loaded directly into Epic allows your contract negotiations team to better prepare for upcoming contract negotiations using actual claims data. Your negotiations team can quickly and easily evaluate any changes to future reimbursement models or methodologies, putting your team in control of the negotiations.
Accurate price transparency and cost estimates
HealthBPM can help you differentiate your cost and services from other care systems by increasing the accuracy of your patient estimation tools within Epic. Calculate actual expected costs, instead of using an average payment range from historical claims. Get up-to-date deductible and coinsurance information directly from payers. Your patients will appreciate knowing how much they need to pay after their benefit plan has been applied to their requested services.
Our approach at HealthBPM is to look at both the behavioral and technical aspects of an opportunity for improvement. Not only do we examine the processes, systems and data; we also evaluate the organization’s communications, governance, and team effectiveness.
HealthBPM will perform a quick (2-4 week) evaluation on a specific group of selected contracts that you currently have built into Epic’s Resolute module. We will then compare what is in the system to the actual contract and provide you a gap analysis of where there may be improvement opportunities.
The HealthBPM team will provide a comprehensive evaluation of the entire billing process, team effectiveness, and system functionality. We will perform a business process assessment; evaluate the work queue set-up and design, decision making on visit file orders, and automated payment variance. Our team will also analyze all of the payer contracts currently loaded into Epic’s Resolute module and compare them to the actual contracts. We can also evaluate the current skills and capabilities of your team to offer recommendations for additional training. In addition, we will review how finance is using the expected claims calculation in the accounts receivable and claims reserve methodologies. Finally, we will review your organization’s reporting capabilities.
At the end of the Payer Contract Management healthchecksm, we will produce an executive-level report that indicates the areas at risk, recommendations for change, and an actionable plan for measurable improvement with expected financial outcomes.
Our team will help your organization stay up-to-date. HealthBPM assists your revenue cycle team with the ongoing management and maintenance your payer contracts loaded into Epic Resolute. Our healthmanagedsm service creates an efficient way to manage the higher volume activity during the contract negotiations and new contract loading periods without having to hire additional employees.
Rely on HealthBPM for your Epic Resolute needs
HealthBPM can support your organization with improved contract management functionality and additional staffing when needed. Whether it’s hospital & physician billing, expected reimbursement contracts management, contract modeling, or patient cost estimates, HealthBPM has you covered.