Hospice & Home Health Revenue Cycle Management Solutions

Home health services are in high demand as people strive to move care to a lower-cost setting. Yet many hospice and home health agencies struggle to improve profitability even despite the boom in business. Changing home health reimbursement rates make it difficult to manage hospice and home health revenue cycle effectively. With the rise in high-deductible health plans, more emphasis has been put on maximizing collections from patients while maintaining efficiencies with private insurance and government payers collections. Hospice and home health organizations need revenue cycle solutions that maximize revenue across the board.

CRYPTON’s powerful data-driven platform integrates with your existing systems, helping you streamline processes and recoup and retain every dollar to which you are entitled. Take your hospice and home health revenue cycle management (RCM) to the next level by reducing resource constraints and increasing revenue capture.

Want to learn more? Take a tour of CRYPTON’s dynamic home health and hospice revenue cycle solutions:

Verify eligibility and identify hidden coverage.

Home health covers a wide variety of services that may or may not be covered under an individual’s health plan. That’s why real-time insurance verification is critical. Patients may have Medicare, Medicaid, a supplemental policy, other health insurance coverage, or a combination of these. In some cases, coverage may have lapsed entirely. That’s why you need hospice and home health RCM solutions that give real-time eligibility information and specific details about coverage for medications, wound care, hospice care, palliative care, physical therapy, occupational therapy, and more. Here’s how CRYPTON can help:

Eligibility Verification

Ineligible patient insurance coverage is one of the leading causes of payer claim rejections and denials. CRYPTON’s Eligibility Verification solution provides customizable and easy-to-read payer responses. Beyond insurance eligibility verification, CRYPTON includes co-pays, deductibles, inpatient days used, and other pertinent benefit data. Armed with this information, you’ll be able to make payment arrangements and increase collections prior to rendering services.

Coverage Detection

A surprising percentage of your self-pay and charity patients likely have full or partial insurance coverage that your organization may not be aware of. CRYPTON’s Coverage Detection solution provides powerful, proprietary intelligence based on a decade of data from hospitals, health systems, physicians, specialty groups, ancillary providers, and payers.

Capture revenue with point of service and self-pay patient collections.

High deductible health plans continue to plague providers, and home health agencies are certainly no exception. Your home health agency must develop strategies to engage patients, many of whom are completely homebound. As a hospice or home health provider, you need RCM solutions that make it as easy as possible for patients and their families to manage healthcare expenses and pay you with ease. Here’s how CRYPTON can help:

POS Collections & Processing

High-deductible health plans and self-pay patients make patient financial responsibility a key part of your revenue stream. Not only must you collect more money directly from your patients than ever before, but you also need to keep them happy while you’re doing it. That’s the only way to build patient satisfaction and loyalty.

Patient Notebook

Today’s consumers want the convenience and ease of paying their bills online, and that desire doesn’t change when those consumers become patients. CRYPTON’s Patient Notebook, a patient payment portal, provides a secure online patient payment center where you can send statements, collect payments, and more via a secure and safe channel.

Patient Statements & Communication

Patients often delay paying their healthcare bills—or refuse to pay them at all—simply because they don’t understand what they owe and why. These bills may take hours of staff time to create, fold, stamp, and address, not to mention the cost of postage and returned mail. With CRYPTON’s Patient Statements, you can design, create, and send patient statements that are easy for patients to understand and that drive reimbursement to your preferred payment options.

Accelerate cash flow with claims reimbursement solutions.

When you spot potential claim errors prior to submission, you begin to circumvent denials. The result: you limit the amount of time and resources necessary for appeals. To enable this type of efficiency, however, you need hospice and home health RCM solutions that monitor coding accuracy in real-time, alerting you to potential errors and omissions. Understandably, a large portion of home health and hospice reimbursement comes from Medicare, so you need a tool that offers CCI edits and coding tools, as well as access to Medicare FISS Direct Data Entry system to easily edit Medicare Part A claims. As a hospice or home health provider, you also need the ability to post payments electronically, track denials as they occur, and expedite denial and appeal management. The insights gained from advanced reporting not only improves home health reimbursement but also drives immediate process improvement. Here’s how CRYPTON can help:

Claims Management

Filing claims and collecting payments from commercial and government payers is the financial lifeblood of your organization. Powered by insights drawn from CRYPTON’s network of thousands of providers and organizations, our award-winning claims management software streamlines and automates your entire workflow for faster and more accurate medical claims processing, lower costs, and higher efficiency..

Payment Analytics.

Optimal revenue performance hinges on constantly monitoring key performance indicators (KPIs) and acting decisively to address issues before they significantly impact your organization.

Denial & Appeal Management

The time-consuming process of denial management—which includes tracking claim adjudication, identifying denied claims, researching reasons for denials, collecting necessary documentation, and writing and submitting appeals – need not be so laborious. CRYTPON’s Denial and Appeal Management solution reduces the time spent researching the denial and appealing each claim.

Remit Management

Lost claim remittances and the time-consuming process of manually posting payments leads to costly delays, increased AR days, and unrealized revenue. CRYPTON’s Remit Management solution provides a cost-effective way to receive electronic remittance advice from payers and compile the information all in one system, saving you time and reducing manual processes and errors.

Remit and Deposit Management

Historically, reimbursement deposit management has been mostly a manual and time-consuming process, requiring providers to wait for each bank statement to arrive and manually reconcile each remit. Re-association takes multiple resources, and missing deposits or remits can take hours to resolve. CRYPTON’s Remit and Deposit Management solution provides up-to-date banking information so you can quickly and accurately post payments. The solution automates the remit and deposit management process by offering a direct connection to a provider’s banking accounts to save time, reduce days in accounts receivable, and improve cash flow.