REVENUE CYCLE SOLUTIONS

Consulting. Compliance. Collections.

DENIALS

Allow our skilled, experienced staff to advocate on your behalf with payers. ANI’s team of experts will help to rapidly resolve underpayments related to contract, policy, eligibility, billing and documentation. We will reduce denial backlogs, identify root causes of denials and strengthen your revenue cycle performance. It is very important to us that your claims submissions reflect payer compliance updates and regulatory changes. 

ZERO BALANCE PAYMENT REVIEW

ANI Healthcare Solutions’ Zero Balance Payment Review offers the opportunity to reopen zero balance/closed accounts and find out if underpayments exist. Providers are often surprised by our results. Even if it is too late to claw back payments, the zero balance payment review opens up vast opportunities to improve processes and ensure higher future revenue. Our review includes all payers: government, commercial and self-funded.

Our Process:

  • Discuss project needs and reporting protocols. Every hospital has different requirements.
  • Draft a work plan, obtain contracts and request system access.

Analyze and Audit:

  • Analyze contracts for possible underpayment and interpretation errors.
  • Review coding, billing, and medical records which affect reimbursement.

Follow-Up, Recover, and Report:

  • Monthly and quarterly reports.
  • Contract and operational recommendations.

Please reach out if you would like to schedule an appointment or obtain a free feasibility study.

 

VARIANCE PAYMENT REVIEW

ANI Healthcare Solutions will work all variances received no matter the dollar amount. Identifying the root cause between the expected payment and the actual amount received could point to an error in the fee schedule or loaded contract. The result of our analysis could disclose important information before more accounts are underpaid or past timely.

The key benefit to our review:

  • Increase claim recoveries and decrease future underpayments.
  • Receive appropriate payment for delivered services.
  • Determine root causes for discrepancies through our monthly and quarterly reports.
  • Gain access to Senior Healthcare Consultants and their capabilities:
    • Knowledge of specific payer payment rules.
    • Managed care contract experience.
    • Government fee schedules.
    • Workers’ compensation state regulations.