The best and most ef cient pharmacy is within your own system.
Reliable RCM services are crucial in healthcare
because they ensure that healthcare providers receive timely and accurate payments for the services they provide. This, in turn, allows providers to focus on delivering quality care to their patients without worrying about financial issues.
Moreover, reliable RCM services can help improve patient outcomes by reducing the financial burden on patients. By ensuring accurate billing and efficient claims processing, patients can be confident that they are only paying for the services they receive, and they can avoid unnecessary financial stress. This can help patients focus on their recovery and well-being, rather than worrying about how they will pay their medical bills.
Top RCM service providers are contributing to this effort by leveraging technology and data analytics to improve the accuracy and efficiency of the billing process. For example, many providers are using machine learning algorithms to detect errors and inconsistencies in medical claims, which
can help reduce claim denials and improve the accuracy of billing. Additionally, some providers are using data analytics to identify areas where healthcare providers can improve their revenue cycle management, such as by optimizing their billing processes or improving their documentation practices.
Overall, reliable RCM services are critical to the success of healthcare providers and the well-being of patients. As such, top providers are continually innovating and improving their processes to ensure that they deliver the highest quality services possible.
In Healthcare Everything's recent edition of the 10 Most Reliable RCM Service Providers For 2023 , we walk you through the complex process of RCM and their patientcentric approach to providing the best innovative and highquality deliverable services.
We hope you have an amazing read!
-Pooja Shah
Company
ACP Billing Services Pvt Ltd acpbilling.com
AthenaHealth athenahealth.com
BOSS Healthcare bosshealthcare.com
Clarus RCM clarusrcm.com
DJ
ACP Billing Services Pvt is a Medical Billing Services company in Orlando, Florida, USA with over 15+ years of Medicare & Commercial insurance experience.
AthenaHealth strives to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
BOSS Healthcare provides wide range of differentiated services spanning the entire continuum of the revenue cycle.
By integrating RCM services with Healthcare Consulting services, Clarus RCM can help hospitals and physicians increase their existing revenue stream, uncover new payment opportunities and elevate RCM performance.
EMPClaims empclaims.com
JTS Health Partners jtshealthpartners.com
EMPClaims is a Revenue Cycle Management company. With over 10 years in the industry, EMPClaims specializes in medical billing & coding, telemedicine, workers comp and patient intake solutions.
JTS offers consulting and operational services that align with performance improvement initiatives of healthcare systems, hospitals and physician practices.
Meraki RCM Solutions merakircm.com
Omega Healthcare omegahms.com
Anurag Mehta CEO
Meraki RCM Solutions is a leading revenue cycle management company based out of Los Angeles, California and with it's delivery center in India focused to provide cost effective process improvement solutions to medical providers and facilities in the healthcare
Omega Healthcare helps payers, providers, and pharmaceutical companies increase efficiencies, accelerate cash flow, and reduce health management costs while enhancing patient care.
Scintillate RCM Healthcare LLC scintillatercm.com
Svast Healthcare Technologies svasthealthtech.com
Hari
Scintillate RCM Healthcare is a cost effective, Revenue Cycle Management Medical Billing company incorporated in Austin, Texas and Chennai, India.
Svast Healthcare Technologies is a trusted RCM and billing partner for physician practices and hospitals. It guarantees to increase practice revenue for healthcare providers with 99%+ collection rate.
Trust plays an important role in the company's business. An established trust encourages the employees to take responsibility in a timely manner to any escalation or query that may come up and make the required efforts immediately.
Hari Shankar CEO
Scintillate RCM HealthCare LLC
Providing high-quality patient care is a priority of every healthcare service provider. However, when the service providers oversee administration work, manage expenses, billing, and handle the first stages of patient accounts, it creates a scenario where seamless execution of the transaction is crucial.
While hospitals, small practices and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. That is where healthcare revenue cycle management comes in.
Healthcare revenue cycle management is the financial process facilities use to manage the administrative and clinical functions associated with claims processing, payment and revenue generation. The process consists of identifying, managing and collecting patient service revenue. The financial strategy is crucial to ensuring healthcare organizations stay in operation to treat patients. Facilities use healthcare revenue cycle management to collect profits and subsequently keep up with expenses.
Enabling a plethora of outstanding services that contribute to enhancing the operational processes of healthcare service providers is Scintillate RCM HealthCare LLC , a costeffective Revenue Cycle Management Medical Billing company that allows the providers to focus on what they do best, i.e., caring for patients while bringing transparency and responsiveness in the business.
Being a perfect outsourcing partner, the company implements an AI-based innovative solution that targets key areas of improvement, such as—placing tools in place to control or eradicate errors in the Data process, maintaining adjustments or effective follow-up on no-activity claims, conversion of paper transmissions to EDI, and increase in Cash liquidation rates—to execute and improve end-to-end Healthcare Revenue Cycle Management and Capital finance.
Under the proficient leadership of Hari Shankar , the CEO , the company operates on a scalable business model that not only meets the business demands quickly but also delivers 'best in class' quality output that is HIPAA compliant.
The Commencement
Scintillate RCM HealthCare started in July 2018, dealing with US doctors and hospitals. The company works on their behalf for insurance and patient handling procedures. It's
been four years and Scintillate RCM has grown in terms of client base and revenue across the US and India. Besides these two countries, the company also plans to expand its services to the UAE market, seeing a scope in medical billing as it has the same billing system as the US.
Hari has been serving the US healthcare market since 2006, climbing the ladder from junior to senior management across multiple companies there. His work was based on a three-year plan. That's when he decided to start a company of his own. Following this thought, he returned to Chennai, India and established a company.
Scintillate RCM manages to drive the team forward and out through challenging times by believing in perseverance and resilience, which are its core values. These values are cultivated within each employee from the beginning to achieve goals efficiently.
Secondly, trust plays a significant role in the company's business. Cultivating a sense of trust among the employees is useful when building a meaningful relationship with the clients. An established trust encourages the employees to take responsibility in a timely manner for any escalation or query that may come up and make the required efforts immediately.
Appropriate outsourcing is essential when a doctor or a hospital is handling a lot of patients on an everyday basis.
Despite the competition in the market where businesses offer the same set of services, Scintillate RCM stands different by relying on AI-based technology. It aims to reduce the providers' man hours and costs and increase ROI through integrating applications and tools.10 Most Reliable RCM Service Providers For 2023
Healthcare providers are often entitled to managing their patient's finances and administration, making it difficult to focus on treating them with quality care.
However, by outsourcing RCM, healthcare providers could reduce their workload, perform all the administration of their partners, and focus on treating more patients with quality care. Scintillate RCM is here for just that. It ensures that all the administrative tasks are taken care of, with revenues falling into their places.
The company takes care of all the aspects of handling the revenue cycle process for healthcare providers based in the US market. Starting from coding, building, and posting AR, to denial management, all services and functions are taken care of. Despite the competition in the market where businesses offer the same set of services, Scintillate RCM stands different by relying on AI-based technology. It aims to reduce the providers' man-hours and costs and increase ROI by integrating applications and tools.
I'm a first-generation entrepreneur who started everything from scratch. It was in 2014 when I asked myself, "Why not start a company and make things better for our clients and employees? Why not change lives?" Although it was just a thought, ultimately, I started the company.
It ran well until the pandemic hit us, and we lost control over the business. We had to lose our people and money. But ultimately, we were entrepreneurs. We learned from our mistakes and bounced back. We started afresh, with a new plan in mind regarding innovations and inventions within the industry, as a way to seek more clients. That kept us going and will do so forever.
I also strongly believe in my employees. Without them, there's no performance, no reputation, and no clients. Hence, I don't consider myself to be a boss, but rather a leader to inspire and motivates them to perform more than what's expected.
For those who aim to become an entrepreneur in the industry, I would suggest that you never invest all your money into your unique business idea, as there will always be mishaps. Just make sure to pump 50% of the money, keeping the rest 50% of the money as a backup when you face failures which are bound to happen 90% of the time.
Secondly, people will always tell you, "No, there's a risk in becoming an entrepreneur." You will also have people who will equally encourage and motivate you. So be bold and brave. That's half the success that you'd achieve there.
Lastly, never assume that you'll start a business and succeed immediately. That's not going to happen. Rather, set practical goals and vision. Entrepreneurship is when you accept the thought that you will make mistakes regardless and learn from them. You have the liberty and strength to handle problems, overcome struggles, accept failures and succeed.
Take, for instance, medical coding. Say, a patient visits a doctor with a complaint that he's having a headache. He elaborates on his problems and related medical issues, in response to which the doctor prescribes some medication. The patient takes the prescription from the doctor and goes for treatment. Medical coding is where the patient's diagnosis, i.e., a headache and procedures, i.e., an X-ray and paracetamol have their respective codes that come under ICD-10 and CPT-4. This form of coding is a primary function of the RCM process. But the authorities in the coding department often tend to make mistakes, as a result of which payments from the insurance are delayed or lost.
Scintillate RCM eliminates this error and performs accurate coding through Artificial Intelligence and automation, ensuring the payments are no longer delayed.
When healthcare providers realize that they no longer have to look after their workflow revenue cycle, but simply rely on specific tools and applications, they buy in and develop a sense of trust towards the company's services and products.
The company has patented multiple tools and applications within the US and India that help its clients to control their errors in coding, demo entry, cash entry and cash posting areas. It understands the importance of running a business that may lose revenue in the existence of an error.
While humans are prone to making mistakes, applications don't. For this reason, the company has submissions, machine learning, artificial intelligence, and incorporated tools which could help the clients in making zero errors, all of which are reviewed with 99% accuracy by its employees, who are ICD and CPC-certified professionals.
This brings a key advantage to the company as it can ensure its clients—an increase in AR cash liquidation rates, gross collection ratio, net collection ratio, and control towards adjustments. In addition, if a team of ten employees are working together on a task, then by using an automation tool, the need for manpower decreases, and 10% of the requirement could be eliminated, saving costs, and profiting from the investment.
In general, healthcare providers usually look for a solution to reduce the losses that they experience. Hence, Scintillate RCM's salesforce, based in the US, begins by proposing a plan to its clients that involve a detailed and descriptive analysis of their current problems, followed by ways to handle them affordably. When these healthcare providers realize that they no longer have to look after their workflow
revenue cycle but simply rely on specific tools and applications, they buy in and develop a sense of trust towards the company's services and products.
It's the trust factor through which Scintillate RCM has come a long way in building relationships with its clients. It has an entire portfolio of client testimonials that demonstrates its position in the market and helps it grow further in accordance with healthcare needs.
Looking forward, the business is heading towards a client growth perspective by partnering with more EHR and EPM providers to create a platform where all the hospitals and healthcare providers could be a part of the platform. Thus, whenever there'd be a requirement in terms of action, they could reach out to the respective professionals.
On this note, Scintillate RCM is expanding across different states of the US, providing multiple specialties to seek more clients and expand the business portfolio. Next, the company focuses on the UAE, as the country is a replica of the US; when it comes to healthcare, Scintillate RCM is currently setting up a business model there and is planning to employ the citizens of the UAE there.
From the business perspective, Hari believes in himself being updated and upgraded along with his employees. He states, "As a company, we motivate our employees to join any courses or curriculum that will help them improve and grow." Hence, the company will continue to change and improve the lives of its clients and employees.
To smoothen the complex process of handling bills,
processing payments and revenue collection, a Medical practice or Hospital must invest in Revenue Cycle Management workflow. It is a process that begins with checking in a patient and ends with collecting patients' payments or writing off the bills.
It probably comes as no surprise that Revenue Management Cycle is critical to the lasting success story of any healthcare organization. Providing such a feasible foundation of incoming and predicting cash, EMPClaims , has the experience and the expertise needed to provide just the right billing solutions to medical practices.
EMPClaims was founded in 2008 by the husband-wife team of Piyush Kedia , CEO, and Snigdha Kedia , COO . Under their leadership, the company focuses on working in tandem with the medical staff to smoothen the entire medical billing and claim process.
In an interview with Insights Care, both Piyush and Snigdha talk about their offerings and how the company has a stronghold in the revenue management industry.
Below are the highlights:
Please brief our audience EMPClaims and how it is currently positioned as a trusted revenue cycle management organization.
EMPClaims has been in business for over 14 years, and as an indication of trust, our first customer from 14 years ago is still our customer. Our average customer is a medical practice with ten plus providers and our customer churn is less than two per cent which is a great metric in this industry.
Tell us more about your offerings, through which you have ascertained your stronghold within the industry.
EMPClaims offers solutions for the full lifecycle of claims management and uses a combination of technology and services to optimize reimbursement and reduce operational bottlenecks.
Patient Intake: The intake process is the starting point of the patient's experience. This involves data collection from the patient, getting prior authorization from the insurance carrier, and collecting any medical records required.
EMPClaims offers a solution to automate this workflow and improve the patient experience with a smooth intake process.
Medical Coding : Incorrectly applied medical codes could result in either a higher payment or under-payments. These situations could cause compliance issues for the practice. EMPClaims has a team of certified coders that can assign the appropriate level of coding to ensure compliance and optimal reimbursement. The team has experience working with E&M Coding and Procedure Coding.
Value-based Care Solutions: The industry shift to valuebased care requires solutions that are different from fee for Service solutions. Fee for service reimbursement depends on procedure coding, and Value-based care requires risk coding.
Most practices have both contracts and need workflows that accommodate both lines of business. EMPClaims technology and workflow solutions allow practices to implement parallel workflows for Fees for service and value-based care contracts.
EMPClaims was founded in 2008 by the husband-wife team of Piyush Kedia and Snigdha Kedia. Piyush Kedia has an MS in Finance, and Snigdha Kedia is a Certified Professional Coder. The company was originally an implementation partner for EHR software and discovered a need in the marketplace for RCM Services. When Piyush and Snigdha started EMPClaims, only about eight per cent of all medical practices used an EHR and this number is higher than 70% now.
This transition has transformed customer expectations and increased the portability of RCM providers. They do not take their customers for granted. They have always used best-in-class technology and process controls to deliver consistent service quality and meet their customers' expectations. They have developed in-house solutions for Patient Intake, Value-based care, Workers' comp, RPA, and data analytics.
Medical Billing : Excellence in medical billing requires process control. Our clean claims submission rate is 94% on average, and we have consistently reached 98%. This level of diligence allows us to deliver a consistently high level of service delivery to our customers.
Workers Comp Solutions: Workers' comp has a much higher level of complexity than regular medical billing. The employer is the insured, not the patient, and fee schedules are regulated at the state level.
This requires a very different workflow and technology that can ensure accurate reimbursement. EMPClaims has developed technology that allows us to ensure claims are accurately processed with consistent payment.
The Husband-wife Team
Piyush Kedia CEO EMPClaims Solutions
What are the biggest challenges you faced during the foundational years of the company? What are the most important lessons you have learned in your career so far?
One of the most important challenges and learning early on was investing in the right technology. Using technology effectively in RCM can drive operational efficiencies and predictable outcomes. The cost of software is an important driver but being able to measure the efficiency cost of the software was equally important.
Over the years, we have chosen to work with customers who choose to invest in good technology solutions and not focus on buying the cheapest product. This allows us to build partnerships with their team and deliver optimal reimbursement.
COVID-19 proved to be the biggest disruptor since the Dot-com bubble. What tactics did you apply at your company to continue its operations and growth?
COVID-19 was a difficult time for the healthcare industry and our customers had to adapt to a lot of changes in a very short period of time. We focused on being a partner and a support center for our customers. Most practices were struggling with the new telemedicine guidelines.
We compiled our knowledge of telemedicine billing on a google spreadsheet and made it publicly available through social channels. We had thousands of billers who referenced it. Most practices were struggling with staff shortages, and we started supporting them with automation and remote staffing solutions that eased their burden and allowed them to take care of more patients.
What would be your advice to budding entrepreneurs who aspire to be revenue cycle management services providers in the industry?
This industry is increasingly being defined by technology instead of people and the only suggestion to future entrepreneurs is that they need to understand the nuances of provider workflows changing payer guidelines.
How do you envision scaling EMPClaims Solutions operations and offerings in 2022 and beyond?
The industry will continue to consolidate and transition to Value-Based Care. We expect to invest more in technology like RPA, HCC Coding and Risk stratification that will allow us to offer a good service at a competitive price and develop technology solutions for the Value-Based Care market to continue supporting this transition. Unless there is a shift in the market dynamic, this would be the focus for the next two to three years.
We expect to invest more in technology like RPA, HCC Coding and Risk stratification that will allow us to offer a good service at a competitive price and develop technology solutions for the Value-Based Care market to continue supporting this transition.
The financial procedure organizations use to manage
the administrative and clinical functions associated with various phases of patient care from beginning to end is known as healthcare revenue cycle management (RCM).
When a patient requests medical services, the process begins and concludes with the collection of all claims and patient payments. In conclusion, revenue cycle management in the healthcare industry is the strategy for streamlining operations, ensuring consistent groups, and making healthcare providers financially viable.
Any business must manage revenue, and focusing on improving the revenue cycle is crucial for increasing claims efficiency and reconciling costs to payments to maximize cash flow. Additionally, data leaks could have significant legal repercussions because important patient information is housed in the healthcare revenue cycle process.
Ultimately, revenue cycle management in the healthcare sector aims to develop a method for identifying and resolving friction points so that organizations can receive full payment for services as quickly as possible.
Let's have a look at the benefits of an effective Revenue Management System :
According to a report from Sage Growth Partners, more than a third of health systems have faced more than $10 million in bad debt every year. The situation is getting worse because bills haven't been paid and claims that haven't been paid or aren't paid enough cost up to $125 billion a year.
When RCM is implemented correctly, denial rates drop, which increases cash flow and speeds up payment times. The procedure improves the system's accuracy and reduces the likelihood of errors occurring during insurance verification, coding and claim processing, thereby increasing collections.
A facility that functions like a well-oiled machine will reduce the administrative burden placed on your staff and guarantee consistent collections, which will keep your organization financially viable. Notably, an electronic workflow can assist in streamlining all aspects of the system, including the coordination of front-to-back communication, timely payment closure for a patient's journey, and elimination of lost paper documentation. This gives you more time to concentrate on providing highquality care.
In healthcare, revenue cycle management is the entity responsible for streamlining the processes. The providers' administrative burden is lessened when the revenue cycle is outsourced and automated, allowing them to concentrate more on providing high-quality care to patients.
With the right technology and skilled revenue cycle management professionals, an effective process that reduces standard billing and coding errors can be achieved. This necessitates streamlining the procedure and enhancing each touchpoint of the patient experience. As you know, patient satisfaction is a factor in evaluating the quality of care hospitals provide. As a result, your patients will experience less unnecessary stress as a result of this.
Denials are the result of payment claim errors. As a result, patients receive better care because your staff has more time to focus on them. Your facility's system will be more accurate thanks to optimized revenue cycle management,
leaving little room for error. You can reduce the number of denied claims and receive reimbursements more quickly if you code the first time correctly.
When you join the proper arrangement of programming arrangements with mechanization instruments, constantly consuming errands like information assortment, protection confirmation, and coding will take less time than physical ones. You can speed up the entire process by automating the steps of the cycle, including data charge entry, eligibility checks, and follow-up payments.
Additionally, you become more effective and efficient when you simplify tasks and offer your medical colleagues and administrative staff a more straightforward system, resulting in faster collections and improved cash flow.
Numerous medical care suppliers require approval for tests, methodology, prescriptions, and other clinical benefits since insurance agencies routinely re-think the choices of specialists.
Software solutions based on rules can quickly analyze coverage eligibility and prior authorization. As a result, there is a significant increase in time spent treating patients and a decrease in routine administrative tasks.
When healthcare organizations rely on manual processes to determine eligibility and authorization, administrative costs rise exponentially. Recent studies indicate that clinics incur approximately $7.50 per transaction for manually performed preliminary charges.
As a dedicated healthcare revenue cycle management and medical billing company with global capabilities and specialized solutions, we can make our workflow and processes more transparent and controllable.
- Shreyasi Shelke
The healthcare consultancy sector has witnessed
robust growth in recent years, resulting in increased healthcare access and coverage across the country. This creates an opportunity and an increasing demand for services; however, it also brings in new challenges for healthcare service providers.
Grasping this scenario, healthcare consulting facilitates the organizations to navigate the usual and novel challenges and actively assists them with immersive strategies to overcome the adversities.
Consultants are also experts in data, analytics and technology. They offer a unique approach to solve the challenges by creating a data-driven approach to improving operations and increasing revenues. They also provide recommendations on the best viable technologies to stimulate organizational growth.
Whether a consulting team is implementing new HIT systems to improve efficiency or modelling and projecting revenue cycles , they build tools to enable healthcare providers to improvise their operations eventually.
This is where JTS Health Partners shines as an exceptional healthcare management consulting firm . It is focused on enterprise Revenue Cycle Management (RCM), Health Information Management (HIM), Health Information Technology (HIT) and Healthcare Analytics as a Service (AaaS).
Under the leadership of Julie Stewart, CTO and Cofounder , JTS offers consulting and operational services that align with performance improvement initiatives of healthcare systems, hospitals and physician practices. In an interview with Insights Care, Julie sheds light on the
company's legacy, her professional tenure and valuable opinions on the company's future.
Please brief our audience about JTS Health Partners and how it is currently positioned as a trusted revenue cycle management organization.
JTS Health Partners was established in 2009 under its holding company, JTS Ventures, Inc., (est. 2002). Our internal goals are simple; every client is a reference, and we pride ourselves on having 95% referrals over the past decade.
As a company, JTS is determined to assist healthcare executives with the delivery of the highest quality of services (internally and externally) with a focus on a "best in class" customer service model. Because the complexity of the healthcare environment continues to grow, JTS continuously improves and expands our expertise so we can remain "trusted advisors" for our clients.
JTS serves as a trusted advisor to executives and management teams and remains focused on providing our clients with tremendous value and level of service.Julie Stewart CTO and Co-founder JTS Health Partners
Tell us more about your offerings, through which you have ascertained your stronghold within the industry.
JTS serves as a trusted advisor to executives and management teams and remains focused on providing our clients with tremendous value and level of service. Our trademark is client satisfaction, and our client representation remains within many of the top nation's healthcare organizations.
Utilizing our Revenue Cycle Management historical expertise, JTS created RCM Analytics, n CREAS™, a proprietary, predictive, prescriptive solution for enhancing operational and financial performance. JTS applies n CREAS™ to consulting, operational support and/or EBO solutions for clients to enable greater productivity, focus with precision and revenue goals.
A substantial portion of our Revenue Cycle Management service is through our Extended Business Office (EBO) solutions. Our EBO solutions provide expertise, support and staff augmentation in healthcare revenue cycle. JTS can support a particular interim goal or partner to drive greater efficiency and outcome for your revenue cycle organization by partnering to reduce accounts receivable inventory.
Our Health Information Management services and solutions offer consulting, coding, auditing, auditing education, interim management, staffing support, outsourcing and cosourcing models for the acute and physician settings. We combine business operations with information technology to procure, analyze and secure vital protected health information (PHI).
Health Information Technology (HIT) is another area in which we offer consulting, workflow engineering, project management, implementation, cyber, privacy and security for all phases of enterprise implementation.
Our experience within the HIT industry positions us to provide expert evaluations and recommendations to clients that will help to reduce spending, mitigate risks, and improve the overall operational efficiency of their HIT-related workflows.
Julie, tell us about your professional tenure in the industry and your contribution in scaling JTS Health Partners' success to greater heights.
I have spent the better part of three decades creating business solutions combining consulting and technology. I have enjoyed creating solutions that enable accurate and
time effective business decision opportunities for business leaders.
My background in software design and development, solutions design and implementation, network operations, project, and program management, as well as organizational management, helps me lead both internal and clientoriented services and solutions.
In addition to leading the rollout of the analytics platform, nCREAS™, I lead the Technology and Operational organizations to ensure effective and secure workflow processes. Managing the risks of our clients and the privacy of their patients is one of my top priorities, which includes managing the methodology around People, Process, and Technology.
I am a metric based, results-oriented executive with information technology, consulting, organizational management experience focused on improving the outcomes of healthcare organizations.
What are the biggest challenges that you faced during the foundational years of the company? What are the most important lessons that you have learned in your career so far?
While assuring the most significant industry expertise to our clients, our earlier years provided lessons on establishing shared company fundamental values and recruiting to meet those values in addition to industry and technical expertise requirements.
JTS has developed and implemented a robust cultural program to ensure the execution of our mission is successful, both internally and with our clients. This enables our employees to have a successful professional and personal experience while providing the highest quality of service to our clients.
The most important lesson I have learned personally in my career is to value and trust my knowledge, experience and decision making. For many of my early career years, both technically and organizationally, when directions were challenged, I spent an exhausting amount of effort questioning accuracy and validity.
While it is extraordinarily important to value collaborative thoughts, ideas and opinions from colleagues and other experts, age and experience have taught me the value of my knowledge and experience depth, making a more straightforward process toward desired goals and outcomes.
COVID-19 proved to be the biggest disruptor since the Dot-com bubble. What tactics did you apply at your company to continue its operations and growth?
The pandemic greatly impacted all aspects of our economy, and healthcare more than any other. Hospital labor shortages and increased costs continue to impact the industry. As a revenue cycle management company, JTS was fortunate to have remote office technology and processes already in place and the ability to quickly transition more staff to virtual workspaces.
Comprehensive technology and established security processes and procedures for managing PHI and maintaining HIPAA compliance is of utmost importance in the remote work environment. JTS' ability to quickly pivot and provide staff augmentation and interim management has helped our clients navigate this difficult labor environment.
Additionally, JTS took a long-term approach to the uncertainty of these years. We applied more planning, design, development, and implementation of key analytics platforms to support precise understanding and accurate decision making to leadership in the revenue cycle organizations of health systems.
Analytics are key to improving decisions and enabling an organization to continue forward, even while labor shortages abound. Within HIM and RCM service lines, improving our platforms to provide additional insights has been invaluable to our customers.
What would be your advice to budding entrepreneurs who aspire to be revenue cycle management services providers in the industry?
New insights and applied learning are vital to both personal and industry success; that concept is not any different for the revenue cycle management space. Healthcare is not only ripe for, but now ready for, modern technologies. For young entrepreneurs, I would encourage them to learn and grow within the revenue cycle space to apply new technical insights to business needs to improve health service providers.
The industry is ever-changing and evolving, and their ideas, knowledge and applied contributions can and will be effective. Making a difference to improve the revenue of the hospital and physician systems enables consistent and improved care to be provided to patients.
How do you envision scaling your company's operations and offerings in 2022 and beyond?
JTS prepared for future growth by investing expertise and development in analytics applied to the whole revenue cycle practice to pinpoint decision making, process improvement initiatives, and consistent education for our clients. The use and accuracy of these tools are critical for the speed and efficiency of revenue deliverables.
As a revenue cycle management consulting firm, JTS is apt to scale staffing for any part of the revenue cycle for our client engagements. The increase in remote work-based arrangements has only enhanced our commitment to apply the right talent for each client to achieve measurable and high-quality results.
Please give us a few testimonials of your clients/customers and awards/recognitions that accurately highlight your company's position in the market.
"JTS is a client-driven organization. You will have their attention, including reasonable response time from Tom Stewart, and they will make you feel like you are the only client they have." William Franquet, Vice President, Revenue Cycle, Evangelical Community Hospital.
"JTS Health Partners is a highly professional organization with honesty and integrity. Their change management and information technology leadership and expertise within our Cerner Clinicals, POE, and Physician Adoptions projects were excellent. They truly operate as a 'Trusted Advisor' to our organization." Pam Austin, Chief Information Officer, Ballad Health.
"JTS Health Partners is a true partner. They go significantly further than the typical consulting group to clearly understand your needs, challenges, and specific circumstances to provide the best solution for the situation at hand." Jann Lefler, Retired – Former Director, Financial Planning and Decision Support.
Out of all the reasons adult children may choose to hire a live-in caregiver, mental health may not be the first reason they give. That is because when they finally get to the point to hire, there is already a pressing concern that their loved one cannot be alone, and the family members do not realize the mental health impact they are currently experiencing. However, looking deeper, there is a two-fold benefit for our clients and their families. Hiring a live-in caregiver is beneficial for a client's mental health because it can make them feel a sense of safety and security.
In the outbreak of COVID-19, the world was forced to shut down; everyone needed to isolate not only for their safety but as well as their families. From my experience working as a nurse during the pandemic, I saw how tough it was for those who lived alone and those who depended on their relatives to assist them with their ADLs (Activities of daily living) and IADLs (Instrumental activities of daily living).
All of a sudden, the only form of communication they had with their families and friends was by phone. I started to notice more behaviors were occurring, and frequent falls
were happening. It was clear to see the negative mental impact our clients were feeling.
What we discovered was that the families were searching for solutions, feeling vulnerable and guilty. Many asked, "should I take my mom or dad home?" sometimes ignoring that they did not have the adequate space at home, training, or the capacity in their schedules to dedicate the time and attention to their loved ones needed to thrive. When I started the business with In home personal services , I noticed that most of my clients' families lived out of state, which led to heightened levels of poor mental health due to a sense of helplessness the families felt. After speaking with the families to identify their needs and provide education and reassurance in our services, they could feel a sense of trust in our caregivers as if they were an extension of their family.
Knowing that our caregivers were well-trained, professional caregivers gave them a sense of ease. The caregivers were by their side, giving only their full attention to their clients and allowing the pandemic to be bearable. They attended to their needs and wants but still allowed them to maintain their independent lifestyle.
Overall, there are not many words to describe the peace of mind when it comes to the ones we love, and we do not often realize in our busy lives how our mental health can be affected for someone we love is not getting the care or attention they need. We are so proud to be offering this type of service to improve the quality of life for our clients as well as the mental health of their families.
- Rachelle Ventura, RN
You are the beginning of a responsible business.
Responsible business depends on your values and actions, as well as whether you actively embrace transparency in your business decisions, whether you are a young professional at a large company or a young entrepreneur.
Today's young professionals and entrepreneurs are held to a high standard and expected to implement transparency early in their businesses. When it comes to issues about a company's performance, internal processes, sourcing, pricing, and business values, it is essential to be open and honest about its operations.
The key to creating a positive work environment is transparency. Employees will begin to make educated
guesses about the company or their colleagues if they fail to be open about your business operations. Unnecessary rumors and gossip result from this. As a result, your company's culture should be heavily influenced by transparency.
Let's take a look at the main benefits of enhancing financial transparency!
The internal report about the trading disaster at the bank mentioned above said that "no initiative was taken to check the truth of affirmations" provided by the trader, "even when they lacked probability." The signs weren't generally
hailed to bosses, and "when the ordered progression was cautioned, they didn't respond," the report said. The trader asserts that his superiors must have known what he was doing because he was making a lot of money.
It's a fascinating tale about how failure blinds people. "The stars were making money, so we left them alone" is a common refrain. It is also interesting how frequently we hear a statement of plausible deniability: "When circumstances change, the losses accumulate, and fingerpointing begins," We had no idea what they were doing or the dangers they were putting themselves in. By itself, that statement suggests a failure in governance. This theme's contribution to compensation is also a governance issue.
Asset and enterprise value protection may be as significant over the long term as enterprise value creation. The shockingly significant losses businesses suffer due to the unauthorized or improper use of financial derivatives have undoubtedly dominated the news.
Because their actions or inactions can potentially expose an organization to significant risks, the employees hold positions that we might call "trust positions." While skilled individuals are many viewpoints on overseeing risk, depending on them without free checking and detailing is as stupid as not figuring out the dangers inborn in their exercises.
An enterprise risk assessment (ERA) is a systematic, forward-looking analysis of the impact, likelihood, and speed of potential upcoming events on an organization's ability to achieve its business goals within a specified time frame. The evaluation of the available data, metrics and available information, as well as the application of judgment by the stakeholders involved, are all parts of the ERA process.
The most significant enterprise risks ought to be identified first by the ERA. These risks put the company's strategy and business model at risk. They might involve substantial risk exposures.
Second, every company's day-to-day operations expose it to various operational, financial, and compliance risks. These are known as risks associated with ongoing business management. Among the activities generating these risks, numerous trust positions may not be considered essential to the business in the ERA process. They might involve procurement, handling hazardous materials, information technology, customer service, internal operating procedures, and exotic financial instruments.
As GM's Barra acknowledged, culture is crucial to fostering transparency. Managers are encouraged to present the complete picture of potential outcomes of prospective transactions, deals, investments, and projects in a risksensitive and risk-aware culture.
When deciding whether to take advantage of an opportunity, managers should consider the negative and positive aspects. For instance, how bad would it hurt if things didn't go as planned, and is the organization adequately compensated for taking on the downside risk by the potential upside opportunity?
Opportunities tend to captivate managers quickly. Similarly, they may be tempted to make concessions that could jeopardize safety. They might put the upside opportunity ahead of the downside risk.
People can speak up and be heard by decision-makers in a risk-sensitive and risk-aware culture. It provides the organization's members with, Ideally, not just the most intelligent people in the room but all the key personnel.
Promoting financial transparency requires a commitment to openness and a willingness to be accountable to stakeholders. By following these steps, organizations can build trust and confidence with stakeholders and ensure that their financial practices align with their mission and values.
- Shreyasi Shelke
In a world where the evolution of technology is at its peak, medical science is also experiencing innumerable advances. Quality improvement in healthcare means a systematic approach by a healthcare organization that monitors, assesses and improves the standards of quality healthcare.
Any healthcare organization can exert some control over internal dynamics, such as provider productivity, patient volume and fees for services. However, it is an arduous task to influence external factors such as patient payments or claim reviews from insurance companies. RCM plays an important role especially for hospital-based physician specialties, due to the complexities of billing and revenue collection.
Svast Healthcare Technologies is one of the leading endto-end revenue cycle management organizations trusted by independent physician practices offering solutions to access the financial health and well-being of the practice in a practice evaluation.
The company's mission is to improve the financial performance of independent practitioners by delivering
personalized service through best-in-class people, processes and technology
In an interview with Insights Care , the team of Svast Healthcare Technologies sheds light on the company's journey as a trusted RCM organization in the healthcare niche.
Please brief our audience about Svast Healthcare Technologies and how it is currently positioned as a trusted revenue cycle management organization.
Our services include New Practice Set-up, Growth Marketing, Credentialing, Coding, Billing, Denial Management, Account Receivable Management, Quality Reporting, Practice Staffing, and Book-Keeping.
Independent practices trust us because they can get all their needs taken care of in one place, and our team works as an extension of their practice to find out ways to improve the financial performance of practices and patient experiences. We consider our client's business as our business.
Independent practices trust us because they can get all their needs taken care of in one place and our team works as an extension of their practice to find out ways to improve the financial performance of practices and patient experiences.
Tell us more about your offerings, through which you have ascertained your stronghold within the industry.
Our stronghold and consistent results are because we combine deep RCM knowledge of our staff with Six Sigma Quality Processes and use multiple Technology Tools across the RCM workflow combined with the power of Data Analytics. Our fee is the most competitive in the industry for the vast scope we cover for our clients.
Due to limited resources and time, such a unique combination of Knowledge, Quality, Technology and Data Analytics is very hard for independent private practices to develop in-house.
Knowledge + Process + Technology + Analytics also enables us to deliver results and improve private practice revenue by up to 15% on a sustained basis. As a result, our clients pay us only a part of what we add in revenue for
their practices. Therefore, it is a solid win-win proposition that gives us a stronghold in the industry.
What are the biggest challenges you faced during the foundational years of the company? What are the most important lessons you have learned in your career so far?
During the foundational years, the biggest challenge was finding the right team members that had the RCM knowledge and mindset of continuous learning and improvement. The second challenge was to run lean operations to keep funds for marketing to win new clients. As we picked up some steam, the third challenge was to form a culture and Svast way of doing things that channel everyone's energy towards a common goal.
From an entrepreneurship standpoint, the biggest lesson we learned was that we had limited resources – capital and time
and we needed to use them very prudently. Hence, we initially kept our focus on a few specialties and selected geographical areas instead of spreading ourselves thin. That helped us play for our strength, win clients and perform better. And then we slowly expanded to other areas.
COVID-19 proved to be the biggest disruptor since the Dot-com bubble. What tactics did you apply at your company to continue its operations and growth?
We offered financial flexibility either through discounting or delay in payment to our client at the time of COVID. Due to the loss of a few clients, we had to furlough a few employees to manage the costs. We negotiated a lease to end early for the office space and adopted the model for an entire team to work from home. We kept a channel of communication open with our employees about the financial performance of our clients. We increased the marketing spend. Due to these measures, nine months after COVID started, we were on a growth path again.
What would be your advice to budding entrepreneurs who aspire to be revenue cycle management services providers in the industry?
Focus on a certain market or a niche, do not try to be everything for everyone. For example, focus to target clients in a particular specialty or a particular geographical area. Invest in digital marketing for lead generation and growth. Invest in employee learning and development.
How do you envision scaling your company's operations and offerings in 2022 and beyond?
We are adding about 50 new clients every year. We have a very strong marketing, sales and onboarding engine that helps us onboard so many clients and set up the right RCM process for them. To continue to scale, the team knowledge needs to grow, so we are investing in the training of our
employees like AAPC certification, Six Sigma certification, PM/EMR system training, and leadership training. To manage many clients and to improve our productivity and quality, we are also investing in our processes, automation, use of technology and data analytics.
We have recently added Practice Staffing services. Using this service, practices can lean on us to hire staff that works in their practice location, but we provide the benefits and HR management. This takes away a big pain to find and offers good benefits to employees that every independent practice wants but cannot afford. We see this has a major expansion area.
Please give us a few testimonials of your clients/customers and awards/recognitions that accurately highlight your company's position in the market.
"Just wanted to say THANK YOU . We started, I believe, formally around 02 Feb 22 (2/2/22). If you believe in this kind of stuff, Angel Numbers: Number 222 symbolizes faith and harmony. It heralds a new era in your life and ushers in fresh possibilities. Every aspect of your life should be in harmony with one another. And although just over one month, I appreciate you and your team and am grateful to have 'stumbled' across you all”
"My first impression was that I felt secure. The onboarding experience was exceptional. You helped us organize better. We had a point of contact and an IT contact introduced to us via video conference. I genuinely feel confident in the billing company. Your pricing is beyond fair. The quality of service is exceptional. I have to say that we cannot do this without you. We are not going anywhere!!"
