7SEVENSEVENSEVENSEVENWhy top practices hand off billing

to NextGen RCM Services

Seven secrets to getting paid

7“Revenue cycle management work takes diligence

to succeed. NextGen RCM Services digs into the

detail to truly understand the issues and works

closely with us to optimize collections. Whatever is

needed, we can count on NextGen RCM Services.” Michael McManus, Chief Operating Officer Touchette & Kenneth Hall Regional Hospitals

7secrets

There’s too much at stake to let administrative

burdens hamper your ability to practice medicine

and financially thrive. With Meaningful Use (MU)

Stage 2, ICD-10, and an ever-changing healthcare

environment, it’s essential to have a proven technology

solution and partner that supports your regulatory

readiness and helps you resolve billing issues. The right

experts and technology will reduce your administrative

headaches and ensure you get every dollar you deserve.

Find a tailored billing solution packaged in a flexible service model to get support where you need it most.1

Is your practice struggling to handle time- consuming tasks associated with medical billing?

In today’s complex healthcare environment, many practices are struggling with medical billing and recruiting the talent required to stay on top of billing rules. Outsourcing a part of the billing process doesn’t need to mean downsizing staff or handing over complete control of Accounts Receivable.

Services like NextGen® Revenue Cycle Management (NextGen RCM) offer

a tailored billing solution with the flexibility to add resources only where you

need them to fix revenue leaks and optimize your bottom line. NextGen

RCM experts can help with as much, or as little, as needed. In some cases,

your practice may be growing faster than your internal billing staff can

handle. Or, you may not have the physical office space or the full

back office infrastructure needed to support the volume of claims and

credentialing associated with such growth.

Even if you’re not growing rapidly, NextGen RCM Services can help

you retain your staff in the face of change and intelligently re-engineer

employee responsibilities for optimal financial results. With a tailored

solution, rather than taking over the jobs of your current staff, you gain

expertise and support for time-consuming, repetitive billing tasks.

This allows internal staff to focus on higher value activities that can help

maintain and improve A/R, as well as more time to focus on care.

While partial medical billing service packages are a good choice for many

practices, they may not be the best choice for all. It may be more beneficial

for a practice to allow a medical billing service to actually “become” their

billing office, managing the entire claims process.

Choose an integrated solution that covers the full RCM cycle2

Do you have all the pieces in place for a healthy bottom line?

According to the Healthcare Financial Management Association, RCM

involves managing both administrative and clinical functions related to

patient services. But not all billing solutions cover the full RCM cycle.

It is inefficient to switch from an RCM system to a practice management

system, and then, later, open your EHR. A truly integrated system

combines all of this functionality in an organized chronological order

to improve workflow and staff time spent on back end office issues.

This, in turn, will improve your bottom line.

NextGen RCM billing services provide you with everything needed

including EHR, Practice Management, Patient Portal, and appointment

reminder systems. With NextGen RCM Services, our experts ensure

you’re taking full advantage of top tier medical technology to drive

revenue to its fullest potential. Performance is based on more than

just the ability to manage A/R. A one-platform approach connects

and synchronizes the clinical, administrative, and revenue solutions

across all areas of a practice.

From the configuration of appointment reminders and eligibility

verification tools to claims processing, NextGen® technology is

configured efficiently — accelerating revenue while saving time and

money. Denials and appeals are reduced significantly through tools

like NextGen® Real Time Edits (NextGen RTE) providing access to

thousands of the most current payer rules, enabling claim “editing” to

be invoked during the billing process. NextGen RCM Services experts

make sure required edits are applied, ensuring all claims are accurate.

As a result, billing conflicts are addressed immediately. With outsourced

billing, you can take advantage of our top tier technology, dashboards,

tailored processes, RCM best practices, and the advanced reporting you

need for complete control and A/R transparency.

NextGen RCM Services

deliver streamlined

billing processes and

proven methodologies

tailored to your practice.

These methodologies are

easy to navigate and give

you a clear picture of how

fast you are getting paid,

who’s not paying you, and

why you’re not getting paid.

Pick a solution that supports MU2 and ICD-10 readiness.3

Is your technology partner MU2 certified? Are they ICD-10 ready — and helping you get there, too?

The majority of EHR companies offering integrated billing services are not MU

Stage 2 ready. NextGen Healthcare is committed to helping clients meet

ongoing ICD-10 and MU goals—and offers the award winning technology

needed to help you get there quickly. As one of the first three EHR companies

in the nation to have an ONC Certified HIT 2014 Edition solution, we’re built

to manage change and keep you ahead of regulatory demands and risk-based

payment models. NextGen Healthcare is an industry leader and a safe, proven

choice in times of rapid change and uncertainty.

Your technology partner should demonstrate a commitment to client partner-

ships and proven solutions to help you secure stimulus incentives and meet

regulatory requirements. To date, NextGen Healthcare clients have claimed over

$440 million in MU payments. It is also important to look at the overall national

rankings of successful attestations, as well as the attestations success rates for

your specialty areas. Our proven robust system, with strong clinical/specialty

content, can help your practice fully meet MU attestation requirements. We

are consistently ranked in the top four by CMS.

NextGen Healtchare is built to manage change.

ONC Certified HIT 2014 Edition and MU ready!Our ICD-9/ICD-10 Comparison Utility

helps clients evaluate if, and where, they

need additional training on the new codes.

3

4 Demand an RCM partner with proven results.

Does your prospective partner boast impressive outcomes?

A high-quality solution will revolutionize the way your company

operates and help you achieve greater efficiency and better

financial results. With a top-notch billing service like the one of-

fered by NextGen Healthcare, you can expect to reduce

average A/R days by 36% - 37%, to improve collections by 9% or

more, and achieve a first-pass clean claim rate of 97% or higher.

Your billing provider should be able to produce case studies

and proven metrics from actual customers showing measurable

results. NextGen RCM experts can deliver success stories and

offer a free assessment to help you assess your revenue cycle and

practice performance against state and national averages and

identify RCM improvement opportunities.

Our Clients Realize Amazing Results

IASIS Healthcare

• 33% improvement in first-pass clean claim rate

• 9% reduction in denials

• 42.7% increase in cash collections

Capital Women’s Care

• 81% decrease in A/R days to 21.47

• 99% Net Collections Rate

• MGMA top performer

Cincinnati Children’s Hospital

• Decreased A/R days to 20.31 (MGMA average 45.93)

• 89.6% of collections received in less than 30 days

• Aged A/R less than 1.79%

“We thought we were doing well with our clean claims rate before

but NextGen Billing Services increased our clean claim rate

more than 20 percent.”Elisabeth Duhon, Director

Revenue Cycle Management

5 Reduce your administrative headaches with an RCM partner that quickly resolves issues.

“ It starts out with RCM Services

working the denial as much as

possible and fixing it. Issues

such as inconsistent insurance

info or mismatched providers...

are identified and NextGen

RCM Services takes care of it.

With RCM Services, follow-up

time is as quick as possible.

They do an excellent job at

resolving situations.”Keith R. Froleiks, COE, CMA,

Practice Administrator

Would you like to spend more time practicing medicine?

Many RCM service providers say they will reduce headaches

and allow you more time to focus on practicing medicine.

However, they often task all the hard work back to you.

Look for a billing service like ours, which provides the

expertise and specialized advocates that will take on chal-

lenging tasks for you, like credentialing and denial resolu-

tion. As a billing partner, NextGen Healthcare proactively

drives revenue and prepares you for future change by finding

medical billing problems and taking care of them before they

ever come to you. In addition, we analyze your unpaid and

underpaid claims and aggressively follow up with insurance

companies. Continuously monitoring the ageing buckets

of your A/R, we keep in touch with insurance companies to

ensure that claims are settled as quickly as possible.

Partner with RCM experts who will continuously drive results.6

Do your financial results suffer because there’s not enough bandwidth to effectively handle everything?

Good talent is hard to find. Without the right IT systems and expertise,

you can lose patient care time as you struggle to better manage costly

revenue cycle issues like denials and claim errors. To achieve the best

results possible, find a provider with a consultative approach to billing.

One that brings RCM and technology experts together to provide the

intelligence needed to drive results.

Our experts meet regularly with clients and their staff, ensuring they

understand revenue cycle performance metrics, performance drivers,

and any trends that may help them respond to marketplace changes.

You get the expertise and strategic input to turn information into

actionable business insights. The NextGen RCM Services account

manager drives process improvements, system enhancements, and best

practices while acting as your financial analyst. They are experts at using

practice management software and healthcare information technology to

ensure your practice is using them to their fullest potential. They continuously

monitor your key performance indicators — such as your top denials —

providing detailed reports as well as action plans to help you optimize

reimbursements while reducing denials and days in A/R.

The NextGen RCM Services account manager drives process improvements, system enhancements, and best practices while acting as your financial analyst.

“Data is everything to us.

NextGen gives us situational

awareness so we can imple-

ment improvements. It all

works because we have the

right team internally and

externally with NextGen.”Debbie Redd, CEO/President

Capital Women’s Care

Pick a flexible, value-based service provider who won’t drain your wallet. 7

Are you getting every penny you deserve?

Today, keeping pace means not only driving better patient outcomes,

but also running a healthy business. Billing used to be simpler and

price was the driver in choosing a vendor. Today, the standard focuses

on value, results, and meeting ever-changing billing requirements.

Make sure you fully understand a given partner’s ROI potential. Too often,

when outsourcing billing, the promise of reduced overhead costs does not

pan out and the practice ends up disappointed. Flexible value-based

purchasing options offer a pricing model that is not fixed and is aligned

with a practice’s revenue cycle results.

Top practices choose NextGen RCM Services because of our pay for

performance ACO-type model, where we get paid when you get paid.

NextGen RCM Services also offers flexible value-based payment models

and supports alternative payment models—such as those that may

require HCC coding or population health applications.

When choosing a provider,

beware of emerging

ACO payment options

that have recurring standard

fees that can be quite high.

Minimize your risks and

make sure you fully evaluate

and negotiate terms and

don’t overlook any recurring

standard minimal fees that

other vendors may apply.

”

“ A year after our RCM transition, our billing

department team better values their roles and

is more knowledgeable about all aspects of

the billing process. There’s more cross-coverage,

PTO flexibility, and time for special projects.

We’ve stopped drowning in our holding tank. Sarah Ortiz, Revenue Cycle Manager CommUnityCare

Financially Thrive.Reduce or eliminate administrative headaches. Ensure your ongoing

readiness for healthcare change. Tap into NextGen RCM Services to

empower your ongoing success.

Copyright © 2014 NextGen Healthcare Information Systems, LLC. All rights reserved.

NextGen is a registered trademark of QSI Management, LLC, an affiliate of NextGen Healthcare Information Systems, LLC. All other names and marks are the property of their respective owners. Patent pending.

NextGen® Ambulatory EHR version 5.8 is ONC Certified HIT 2014 Edition certified as a complete EHR. For full certification details, please visit www.cchit.org

NextGen Healthcare Information Systems, LLC

795 Horsham Road, Horsham, PA 19044

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insidesales@nextgen.com | nextgen.com

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Take the Next StepContact us to find out how we can help you. Call us toll free at: 314.989.0300 or visit nextgen.com/RCM