Pediatric Practices Revenue Cycle Management

Balancing the business side of Pediatric practices with patient care is no easy task. Today’s physicians face a myriad of challenges related to Pediatric billing requirements, administrative tasks, and more.

The good news is that the right technology solution can make a difference. CRYPTON’s powerful data-driven technology integrates with your existing practice management system, helping you do more with less by automating some of the tasks that can drain your staff members’ productivity. Take your Pediatric practice revenue cycle management (RCM) to the next level to gain the revenue you have earned.

Want to learn more? Take a tour of CRYPTON’s comprehensive Pediatric practice RCM solutions to help optimize revenue:

Real-time insurance verification and the ability to identify coverage in self-pay.

The complexity and variety of today’s health plans can easily overwhelm your busy practice. In addition, lapses in coverage occur frequently as patients change jobs or lose their employment. Other patients may have coverage under multiple plans, only one of which is the primary insurer for billing purposes. It’s a lot to track and validate, yet it’s also a critical part of your reimbursement. Practices that don’t take the time to verify eligibility often find themselves facing denials due to lack of coverage. You need Pediatric practice RCM solutions that not only provide real-time eligibility information and patient estimations so you can educate patients about their financial responsibility—all before services are rendered – but also coverage detection solutions to identify coverage in self-pay after services are rendered.

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-and-a-half of data from hospitals, health systems, physicians, specialty groups, ancillary providers, and payers.

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

The proliferation of high deductible health plans continues to shine a spotlight on a new payer type: the patient. You must increasingly collect entire balances directly from patients—not insurers. And most physicians know that with the rise in healthcare consumerism, patients want easy-to-understand statements as well as a variety of payment options, including online payment or establishing a payment plan. You need pediatric practice RCM solutions that improve collection rates, cater to patient preferences and satisfaction, and improve your overall bottom line.

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 by managing claim reimbursement.

Pediatric reimbursement relies on timely and well-orchestrated claims management. You need solutions that streamline various workflows around claims and remit management, making it easy to process and track claims all while boasting a best practice standard of a 98%+ clean claims rate.

It doesn’t stop there. When denials occur, you don’t always have enough staff members to devise a strategy for appeals. You need Pediatric practice RCM solutions that alert you to potential denials before claims are submitted so you can correct problems on the front-end without affecting precious cash flow and tying up administrative resources unnecessarily. These solutions also enable you to pinpoint the root causes of denials when they occur, and they help you appeal those denials with ease.

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. CRYPTON’s Denial and Appeal Management solution reduces the time spent researching the denial and appealing each claim by as much as 33 minutes versus doing it manually.

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.