Post-Acute & Long Term Care Revenue Cycle Management

Post-acute care providers play an integral role in new care delivery and payment models, yet without a clear strategy for skilled care and long-term care revenue cycle management, these providers run the risk of missing out on valuable post-acute care reimbursement. Limited staff continues to pose challenges for post-acute care providers, making automation a critical component of financial success.

The good news is that the right Billing and RCM Solution can make a difference. CRYPTON Global Services helps you capture post-acute care reimbursement with ease, ensuring accurate long-term Medicare reimbursement as well as precise skilled nursing Medicare reimbursement. Take your post-acute care reimbursement to the next level to gain the revenue you deserve.

Want to learn more? Take a tour of CRYPTON’s post-acute care reimbursement solutions to help optimize revenue:

Verify eligibility and reveal hidden coverage.

Post-acute care coverage is anything but straightforward—especially for Medicare that has different coverage criteria and facility requirements for each post-acute care setting. You don’t always receive accurate insurance information from referring hospitals, nor do you always have sufficient staff to do a deep-dive into each patient’s coverage. You need post-acute care reimbursement solutions that help you verify coverage preceding inpatient stay as well as a solution that detects healthcare coverage that the patient had not provided or was not aware of. Here’s how CRYPTON can help:

Eligibility Verification

Ineligible patient insurance coverage is one of the leading causes of payer claim rejections and denials. CRYTPON’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 solutions.

In the world of post-acute care, patients are often responsible for different cost-sharing amounts depending on the setting in which care is provided. You need post-acute care reimbursement solutions that help you educate patients about their financial responsibilities. Automated post-acute care reimbursement solutions help you collect all long-term care Medicare reimbursement and skilled nursing Medicare reimbursement you deserve.

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 management.

Identifying potential claim errors prior to submission cuts down on the amount of time and resources necessary for appeals. To enable this type of efficiency, however, you need post-acute care reimbursement solutions that monitor coding accuracy in real-time, alerting you to potential errors and omissions. You also need the ability to post payments electronically, track denials as they occur, and expedite denial and appeal management. These insights not only improve post-acute care reimbursement but also drive immediate process improvement. The result? Dollars driven to your bottom line with minimal staff required.

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 talented and experienced claims management team 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.

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.