Revenue Cycle Solutions and Accounts Receivable Management

Early Out Services—Insurance and Self Pay

Utilizing a team-oriented approach, Pyramid offers solutions customized to meet your Business Office needs. Pre-planning with your key business office personnel allows for a follow-up program established in accordance with your policies and created to generate maximum cash collections. Pyramid is prepared to accept and resolve accounts of all ages, from day one to aged receivables. Benefits include:

Accelerated and increased cash flow
Reduction of A/R days and bad debt write offs
Process improvement recommendations
Potential to reduce your existing overhead
Provides ability to focus your staff on collecting more current A/R
Automated workflows using our leading edge A/R management system
Automated letters and statement process
Seamless integration and transparent transfer of accounts to our system

A/R Wind Down and Data Archiving

Your new system implementation is just around the corner. You’ve dedicated a large amount of time from your leadership team and key staff to work on the new system. As a result, your cash collections are down and your days in A/R are starting to rise. There’s pressure to retire your old legacy system early. How do you manage the system implementation and the A/R at the same time and ensure that both tasks are performed well?

Pyramid’s A/R Work Down and Data Archiving solution combines highly trained staff specializing in A/R liquidation and cash acceleration with an active data archiving technology solution that:

Provides a cost effective alternative to working your post conversion A/R internally
Ensures that pre and post conversion cash collections stay at or exceed current performance
Allows revenue cycle leadership and key personnel to focus on successful implementation and training
Provides an active data archiving solution that allows for early retirement of old legacy system, reducing costs by up to 80%

Aged A/R Clean-Up and Cash Acceleration

Unexpected staff turnover or illness, key resignations, or a system conversion. Any of these can temporarily impact your revenue cycle operation, reduce your cash collections, and increase your days in A/R.

Pyramid offers you an onsite, remote or blended delivery model to assist you in cleaning up aged receivables. Our A/R follow-up experts will analyze the aged A/R, prioritize it, and use a variety of tools to collect your cash as quickly and efficiently as possible. As we work the A/R we also categorize reasons for non-payment, payment delays, and denials. We provide you feedback on these and other root cause issues in the form of a monthly report narrative that also offers suggestions for improvement.

Business Office Outsourcing

Utilizing a partnering approach, we offer a total Business Office Contracting solution to bill, follow-up and collect hospital accounts receivable (A/R). Some hospitals experience up and down cycles when it comes to A/R collection performance. Periodic A/R clean-ups may temporarily improve a hospital’s cash flow and place accounts receivable balances at a satisfactory level. As time passes, however, days in A/R and other key performance indicators can creep back up to previous or even higher unacceptable levels. We work with our clients to establish cash flow and A/R balance goals and address the sensitive issue of what to do with the current employed staff.

Managed Care Contracting Assessment

This comprehensive service includes a report detailing the underlying reasons for contract performance issues that may exist, complete with action plans and recommendations for improvement. Our assessment focuses on the key elements of Managed Care Contract Administration, including current systems, reporting capabilities and interviews with key personnel.

Our contract administration reviews are designed to evaluate managed care contracting activities within a hospital, focusing primarily on those aspects that make it difficult to administer managed care contracts. We create an inventory of contracts, analyze each one and summarize our findings in a “contract profile” database, which is made available to our clients after the review. We review current client systems, evaluate contract performance reporting capabilities and interview key departments and personnel in the contracting process. We also speak with major hospital managed care payers regarding current relationships, systems and future plans. Following our assessment we provide a complete action plan for improvement. The plan includes specific recommendations by department, listed in order of priority, starting with the highest financial payback. After our review, we oversee or assist in the implementation of our recommendations.

Managed Care Payment Compliance and Collections

The primary goal of this solution is to insure that you are receiving the appropriate reimbursement per your managed care contracts. We provide feedback to you so that you can work with your payers to insure that future reimbursement is accurate. We review all managed care plans including Medicare Advantage. The Medicare Advantage (MA) review includes identification of missed bad debt payments from the MA plan as well as missed shadow billings.

We’ll model your contracts in our proprietary system, load your 837 and 835 files and identify any underpayments. After validating the underpayments our specially trained staff will follow-up directly with your payers to recover the cash that is due to you.

Day One Billing

Pyramid offers billing services for all major payers including Medicare. Our billing specialists are experts in all phases of claims processing and compliance. Once access is granted, our team can log in and bill directly from your billing system. This real time service provides tracking within your system of any billing activity done by Pyramid on your accounts.

Operational Assessments, Action Plan Development and Implementation Assistance

This comprehensive service includes a report of findings detailing the underlying reasons for any performance issues that may exist, complete with action plans and recommendations for improvement. Following our assessment, we provide a complete action plan for improvement. The plan includes specific recommendations by department, listed in order of priority, starting with the highest financial payback. To achieve a permanent solution, our experienced professionals implement the plan in collaboration with your staff. We offer a comprehensive assessment or can focus on a particular area of concern you may have such as patient access, billing or follow-up.

A/R Management Training

Pyramid’s A/R Management Training program provides the new or less experienced PFS Director with a foundation upon which to further develop his/her receivables management skills. The training is provided by a Consultant who has direct experience in managing hospital revenue cycle operations and includes one-on-one instruction, use of proprietary tools and materials, PowerPoint presentations, and other resource materials. The management of the A/R asset and its impact on the income statement and balance sheet is emphasized.

Interim Staffing

Pyramid provides interim health care professionals to meet your needs. We have a variety of seasoned leaders such as: CFOs, CIOs, Patient Access Directors, Business Office Directors, Reimbursement Directors, and others. Our staff members typically have over 20 years of experience and have the skills to move your organization forward while you search for a permanent replacement.

Credit Balance Adjudication

Many times, the more experienced A/R collection staff is used to resolve credit balances leaving the collections of cash to the less experienced staff. We can enhance your business office operations through our Credit Balance Adjudication program by providing experienced credit balance staff, thus freeing up your most experienced collectors to focus on the collection of cash. Our program also brings your facility into compliance, which is an added benefit.

Revenue Cycle Printable PDF

Accounts Receivable Printable PDF

A/R Work Down & Data Archiving Printable PDF