Overview

Financial clearance activities play a critical role in laying the foundation for a high-performance revenue cycle. Unfortunately, many organizations lack the necessary labor resources, technology, and operational processes to capture all the critical information, eligibility, and authorizations ahead of the patient visit. As a result, roughly half of all denials are now attributed to front-end revenue cycle management issues.

AGS Health’s industry-leading integrated financial clearance model ensures proper alignment among all revenue cycle management functions through a seamless process that follows the patient journey from scheduling to authorization and pre-service collections, providing patient education around expected financial responsibility along the way. Our approach has helped numerous healthcare organizations improve patient satisfaction, increase reimbursement, accelerate cash flow, and reduce unnecessary downstream activity. As a result, our customers can re-deploy internal resources to improve the patient experience and reinvest capital into caregiving capabilities.

Integrated Financial Clearance Overview

SERVICES PROVIDED

Medical Coding The Key to Eliminating Claim Denials and Reducing Administrative Costs

Identify active third-party insurance coverage and benefits to reduce claim submission errors and back-end denials.

Addressing Challenges in Implementing HCC Coding Image

Ensure patients are financially secure prior to service by obtaining timely prior authorizations.

Proactive External Audits and Other Tips for Avoiding OIG Investigation

Prepare for patient conversations on financial responsibility by collecting accurate good faith estimates.

Revenue Cycle Automation Analytics

Secure pre-service collections and patient education on estimated financial liability and payment options.

BENEFITS

Before receiving services, patients obtain clear communication about their financial obligations for services, including costs and payment options, overall satisfaction.

A comprehensive picture of expected financial responsibility results in enhanced transparency and increased administrative efficiencies to optimize collections, streamline billing, and increase revenue.

Verifying and validating insurance coverage and prior authorization requirements at the beginning of the process minimizes the likelihood of claim denials, resulting in prompt reimbursement.

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Provider Enrollment And Credentialing Services Thumbnail

End-to-end enrollment and credentialing help your healthcare facility operate smoothly and efficiently, ensuring appropriate reimbursement for your providers.

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