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How CoreCare’s Clinical Reimbursement Solution Helps with Payment Collection

Ever wondered how you could simplify the complicated process of payment collection in your healthcare practice?

You’re not alone. Payment collection in healthcare is tough.

Providers deal with multiple payers, each with its own system.

Plus, payor systems rarely communicate with provider EMRs, leaving a lot of manual work that costs both time and money.

In fact, healthcare providers spend a staggering $300 billion a year just to get paid, and even then, many collect less than they’re owed.

For skilled nursing facilities (SNFs), this situation is even worse.

With increasing costs and complicated reimbursement processes, many SNFs face critical financial challenges, often losing money due to missed payments or denied claims.

But here’s the good news—CoreCare’s clinical reimbursement solution is here to change that.

By securing faster payments and reducing write-offs, it helps SNFs improve cash flow and focus on what they do best: delivering top-quality care.

CoreCare: Simplifying Billing and Payment Collection for Healthcare Providers

Simplifying Billing and Payment Collection for Healthcare Providers

CoreCare, a leading provider of revenue management services, helps healthcare companies streamline their billing and payment processes.

Using machine learning, CoreCare automates billing, paperwork, and revenue cycle management, significantly reducing administrative burdens for hospitals and skilled nursing facilities (SNFs).

By linking electronic health records (EHRs), Medicare, Medicaid, and payer systems, CoreCare creates a single, unified view of patient data.

This allows healthcare providers to automate workflows and eliminate manual tasks, resulting in fewer payment delays and reduced costs.

With a subscription model ranging from $300 to $500 per facility, CoreCare is transforming how healthcare providers manage their revenue.

“We’re proud to be one of CoreCare’s first partners in Ohio,” said John Renner, CFO of United Church Homes. “We heard how SNFs were using CoreCare to automate eligibility workflows, and we knew we had to bring that level of innovation into our organization. Our facilities, regional and corporate staff now have a powerful platform that simplifies our operations, improves our cashflow, and increases our revenue.”

CoreCare’s Solution: A Model for Payment Collection

CoreCare’s

CoreCare is an example of how to simplify the payment collection process in healthcare. Their solution is designed to make things easier for providers. Here’s how they do it:

1. Automation at Its Finest

CoreCare automates manual tasks like claim scrubbing, eligibility verification, and payment posting. This saves time and reduces costly errors for healthcare teams.

2. Intelligent Claim Routing

Their system intelligently routes claims to the right payers, ensuring quick and accurate processing, which helps minimize delays.

3. Real-time Insights

With advanced analytics, CoreCare allows providers to track the status of their claims, identify potential issues, and take proactive measures to improve reimbursement rates.

4. Patient-Friendly Billing

CoreCare also offers patient portals and online payment options, making it easier for patients to manage their bills and stay informed about their accounts.

By examining CoreCare’s approach, healthcare providers can find inspiration to develop their own solutions for streamlining payment collection and enhancing revenue management.

Clinical Reimbursement Solution: The Success Behind CoreCare

At the heart of CoreCare’s success is its robust healthcare reimbursement solution.

This solution addresses one of the most challenging aspects of healthcare management—getting paid.

By streamlining the reimbursement process, CoreCare helps healthcare providers minimize claim denials, reduce administrative costs, and get paid faster.

With intelligent automation, CoreCare eliminates much of the manual work involved in claim processing, ensuring accuracy and speed.

Their real-time analytics offer valuable insights that allow providers to identify and fix potential issues before they become costly problems.

Additionally, their patient-friendly billing options enhance the overall patient experience while improving cash flow.

This focus on efficient, tech-driven reimbursement management has made CoreCare a trusted partner for healthcare providers looking to optimize their revenue cycles and reduce financial stress.

It’s clear that their success is rooted in their ability to simplify and enhance the entire reimbursement process.

Features of Clinical Reimbursement Solutions

Patient Pre-Registration

  • Collects personal information, insurance eligibility, and provider details.
  • Ensures complete patient demographics and clinical data for faster, error-free claims processing.

Coding Compliance

  • Automated coding compliance to minimize denials.
  • Streamlined coding workflows integrated with centralized compliance platforms.
  • Improves clinical documentation and auditing processes for accurate claims submission.

Document Management

  • Enhances clinical documentation for accurate reimbursement.
  • Supports complete and precise documentation for payers.
  • Helps increase claims, reimbursements, and overall revenue.

Claims Management

  • Automated claims management to ensure accuracy and prevent denials.
  • Optimizes workflows and checks every code before submission.
  • Identifies potential errors and provides detailed explanations for corrections.

Denials Management

  • Systematic identification and investigation of claims denials.
  • Categorizes denials and develops effective plans for resubmission.
  • Tracks areas for improvement to minimize future denials.

Contract Management

  • Automates tracking of insurance contracts and policies.
  • Creates a database of contracts, policies, and fee schedules.
  • Helps providers track reimbursements and identify due payments.

Architecture-of-Our-Healthcare-Reimbursement-Solutions

Technologies Powering Automated Clinical Reimbursement Solutions

When it comes to automated clinical reimbursement solutions, leveraging cutting-edge technologies is key to ensuring high performance, flexibility, and scalability.

Here’s a look at some of the essential technologies making a difference:

1. RPA (Robotic Process Automation)

RPA uses software bots to take over repetitive tasks in the reimbursement process.

These bots can be easily set up to perform specific billing functions, saving time and reducing the chances of manual errors.

2. AI (Artificial Intelligence)

While RPA focuses on fixed processes, AI brings a new level of adaptability.

By integrating AI, systems can learn from past experiences and make decisions based on dynamic inputs, allowing them to handle evolving billing scenarios effectively.

3. OCR (Optical Character Recognition)

OCR technology is crucial for extracting data from images and PDFs and converting it into machine-readable text.

This capability helps process and organize information efficiently from various document formats, streamlining the reimbursement workflow.

By harnessing these technologies, healthcare providers can enhance their clinical reimbursement processes, improve cash flow, and maintain a focus on delivering high-quality patient care.

Automation-tech

Want to Build a Clinic Reimbursement Solution? You Have Two Options!

When considering a clinic reimbursement solution, you typically have two paths: custom solutions and SaaS (Software as a Service) solutions.

While CoreCare offers a SaaS option, building a custom solution could be the smarter choice for several reasons.

1. Custom Solutions

A custom reimbursement solution provides the flexibility to tailor features specifically to your clinic’s needs.

You can design workflows that align perfectly with your processes and adapt as your requirements change over time.

This approach not only enhances efficiency but also allows for scalability as your clinic grows.

2. SaaS Solutions

While SaaS solutions may seem convenient with their subscription-based model, they often come with ongoing monthly fees.

This can lead to a lower return on investment (ROI) in the long term, as you continue to pay for services that might not fully meet your needs.

Plus, you may face limitations in customization, which can hinder your ability to optimize processes.

In summary, while SaaS solutions like CoreCare’s may offer quick deployment, investing in a custom clinic reimbursement solution can provide the flexibility and long-term value that your healthcare practice truly needs. You can also calculate the software cost for custom, white-label and SaaS platform.