"There is a potentially significant amount of revenue unaccountable for within our revenue cycle that needs to be properly identified and recovered. Our cash-flow disruption can be as high as 5% measured against in-network commercial billing"
Med-Enterprise delivers a three-phased solution to successfully analyze, validate and recover hidden or otherwise lost revenue:
1) Insightful Recommendations,
2) CIRCA℠ Proprietary Data-Mining and Systemic Technology, and
3) Negotiation Facts, Support, and Resolution.
1. Insightful Management and Counseling
Med-Enterprise, with over 40 years of experience, knows how the healthcare financial system works. As a pioneer in providing Revenue Cycle analysis and Prompt Pay Revenue recovery, Med-Enterprise provides the leadership and technical expertise to comprehend, discover and maximum recovery. Our diverse team of experts is proficient in the full spectrum of services necessary to deliver on what we promise: healthcare business intelligence, data mining technology solutions, managed care contract negotiations, and litigation fact services. We do this with minimal time investment on the part of the provider. Our mission is clear: to find “hidden or otherwise lost” revenue and return these vital resources to the organization.
2. CIRCA℠ Proprietary Data-Mining and Systems Risk Assessment Technology
Med-Enterprise’s proprietary software CIRCA℠ (Claims Intensive Revenue Cycle Analysis). CIRCA℠ is a highly intuitive program that provides for an analysis of 4+ years, retrospectively, of the prompt pay integrity of payers. This refined and comprehensive look back at revenue billing allows healthcare providers, of varying sizes, to discover potentially significant “missing or otherwise considered lost” revenue. Our technology was specifically designed to analyze data, looking for errors and discrepancies in billing and follow through by producing “actionable” reports, allowing for informed decisions leading towards a resolution to this issue.
3. Negotiation Facts, Support, and Resolution
With exceptionally accurate, realistic models of the funds that have been identified as “missing or otherwise lost”, providers now have the information and the support to begin the process of presenting these identified funds to their payers. We have internally developed and are constantly improving our proprietary technology solution CIRCA℠, to provide the most accuracy and clarity to help in claiming these funds. With better, more accurate information, we have developed proven plans of action and precedence to successfully negotiate and collect payments.