Integral HCS
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Summary of Services

Organizationally, 100% of Integral Healthcare Solutions (IHS) business focus is dedicated to healthcare. The IHS’ leadership team combines for over one hundred years of experience processing every aspect of health care accounts receivable service / outsourcing solutions. While sharing the collective expertise of IHS’ leadership team utilizing best practice methodology, we offer you one of the top right-sourcing solution provider teams in the industry.

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Patient Access Services — Ever increasing focus is being shifted to the front end of the revenue cycle in order to maximize the patient experience, patient information gathering and appropriate clinical and financial data. Maximum cash management & recovery results begin here. IHS can help you optimize performance in these areas:

  • Pre-registration, Insurance verification, Pre-authorization, Certification
  • Financial counseling, Point-of-service collections
  • Other patient access services

Insurance Billing and Follow Up — Timely and accurate account management of insurance claim reimbursement continues to pressure provider resources due to complexity, volume and staffing levels. IHS can provide relief for these pressures on a short-term or long-term basis by scaling its support to your specific needs:

  • Billing and re-billing of medical claims
  • All payer financial classes and ages up to timely filing limitations
  • Scalable contract terms; short-term, long-term, by payer, age or blended
  • Out-of-State Medicaid: with or without provider packets
  • Full account resolution, including contractual and other uncollectible balances for write-off

Conversion Support — Various system conversions typically put pressure on resolution and aging of pre-conversion receivables. IHS will support your objectives of maintaining account aging and preparing optimum forward flows of staff training, new receivables and new system processes:

  • Work aging receivables from existing platform and/or transfer to IHS systems
  • Billing and follow-up of claims to gain payment and total resolution of accounts
  • Identify claims in need of immediate attention and provide timely and focused recovery campaigns
  • Provide detailed reports to show status of accounts in portfolio.

Denied Claims/Zero Balance Resolution Management — Rework and research of under paid and denied claims is quite costly and time consuming. It also drags down the performance of staff and cash flow working to maximize new claims and patient recovery. IHS will assist in:

  • Adjudicating disputes with third party payers to bring timely resolution
  • Recovery success with all third party payer sources
  • Utilization of proprietary techniques and caseload to achieve high levels of success
  • Assurance that payers abide by rules and policies governed by the insurance industry as well as local, state and federal government

Self-Pay and EBO Portfolio Management — Self-pay and patient portion receivables are growing at unprecedented rates. Costs associated with reducing these obligations are growing as well. The difference between a positive bottom line and provider losses are traced directly to these pressures. IHS will provide scalable staffing, process & technology resources to deliver:

  • Early Out recovery on aged self-pay balances
  • Patient installment payment monitoring
  • Patient Funding Sources
  • EBO support scalable to volume, balance and age ranges
  • Integrated Zero day follow-up services

Eligibility Discovery Management — Payer complexity and funding pressure is making it harder for patients of all backgrounds to seek, secure and enroll in various sources of eligible coverage. Dedicated, experienced focus on maximizing the cost & benefits of best practice eligibility discovery can have a significant impact on your organizations bottom line. IHS can provide that focus on:

  • In-state or out-of-state Medicaid eligibility
  • Federal, State, County & Local programs
  • Provider specific programs
  • Coverage for inpatient, outpatient, emergency department, maternity care, etc
  • Accompany patients on appointments related to retroactive eligibility determination
  • Counseling relative to assistance program availability

Temporary Staffing and Training — Staff recruitment, training and retention of experienced personnel is critical to the on going cash recovery success of any providers revenue cycle program. IHS will support these efforts by providing or recruiting experienced staff on your behalf. Services include:

  • Recruiting, Pre-screening, and Employment Verification
  • Coverage for vacation, leave-of-absence, illness, special projects or to reduce overtime costs
  • Accessible, experienced staff available for temporary to full-time positions
  • Special, Scalable Assignments, Clean-up Projects, and Consulting Services
  • Off-site programs for clients with large-scale projects or staffing and space limitations

Business Office ConsultingOften times, another set of experienced eyes will bring fresh process and operation ideas to your challenges. Understanding your operating environment as well as potential alternative processing resources, can provide excellent vision into change-management opportunity. IHS contracts for these assessment and analysis enhancements in areas such as:

  • Self-pay / insurance recovery process evaluation
  • Staffing / process volume analysis
  • Recovery / cost analysis
  • Technology / analytics enhancement analysis
  • Process redesign / alternative resource analysis

Total Business Office Outsourcing (BPO)In today’s challenging revenue cycle environment, the objectives of reducing administrative overheads, decreasing operational resource commitments and optimizing cash flow performance have never been more prominent. IHS offers the efficiencies of right-sourcing various business processes that will provide improved and accelerated results.

Through a collaborative right-sourcing relationship with IHS, providers will realize the savings and improvements so badly needed to impact their bottom lines and resource allocation pressures. We encourage you to contact us for a confidential review of these opportunities.

Vendor Consulting, Contract Fulfillment, Sourcing Transitions — Many provider relationships with their vendor partners are ineffective, have become outdated or where ill conceived from the start. IHS’ partnering experience can assist you in evaluating these relationships, upgrading to present day values or transitioning these relationships too more appropriate settings including in-house. Services include:

  • Receivable Vendor Analysis and Audit Review
  • Vendor Impact on Internal Process Objectives
  • Vendor Recruitment and Project Implementation
  • Contract & Service Level Agreement Negotiations
  • Sourcing Transition / Implementation Support

Collection Services — In the event that third-party collection recovery resources are of interest, IHS offers the following service relationship opportunity through it’s affiliation with Integral Recoveries, Inc. Service offerings can be viewed at www.integralrecoveries.com and include:

  • Professional and diligent approach to bad debt management
  • Custom collection campaigns
  • Small balance collections
  • Collection training and education seminars
  • Attorney services
  • Skip-tracing services
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