Top 3 Critical Revenue Cycle Management Software Features for Hospitals

Doing things the old-fashioned way may sound like a return to a simpler time, but the reality is that the old ways often create more work and carry a significantly higher margin of error. This is especially true in the world of healthcare billing, where analyzing contracts and crunching numbers by hand used to require entire teams of people and produce subpar results. To make the healthcare billing process more accurate and efficient, CostFlex has created healthcare revenue cycle management software.

Whether your organization is a small clinic or a large hospital, our software is designed to improve every aspect of the revenue cycle. How? By combining 3 critical payer processing tools into one user-friendly suite. We’ll walk you through them one by one.

1. Payer Contract Analysis

CostFlex’s Payer Contract Analysis (PCA) tool allows you to input the details of your previously negotiated contracts into an internal database. Once that’s complete, our software will provide instant insights into a number of analytical reference points and cost-saving tactics. Here are some examples of the ways PCA can help:

Instantly See the Contractual Amount of a Given Service

  • Every contract (government and commercial) is broken down and stored indefinitely
  • Break-even costs and charges for individual services are also stored
  • PCA utilizes both data sets to give you your allowed amount for each service under the relevant contract
  • Users can retrieve the information they need in advance or at the time of service

Effortlessly Identify Underpayment and Overpayment

  • Compare payments received to contractual obligations
  • Automatically flag underpayments to ensure you don’t lose money
  • Automatically flag overpayments to avoid any costly audits

Know Your Write-Offs Ahead of Time

  • Instead of relying on projections based on prior years, accurately calculate your adjustments in advance

Prepares Data Relevant to Contract Negotiations

  • Easily access statistics that provide leverage in negotiations
  • Account for year-over-year cost increases
  • Run “what-if” scenarios to determine best payer proposals

2. Pre-Billing Charge Error Auditor

CostFlex’s Pre-Billing Charge Error Auditor is a specialty software that helps healthcare providers mitigate costly and time-consuming patient billing errors. Instead of waiting until the damage is done, Pre-Billing Charge Error Auditor automatically identifies and flags errors during the billing suspense period — allowing you to rectify the situation before it ever reaches the patient.

Pre-billing software options might be increasingly prevalent, but CostFlex’s unique Pre-Billing Charge Error Auditor stands above the rest. Here is why:

It Is Targeted Specifically to Medical Billing

  • Most pre-billing software is designed to be a generic catchall for a variety of different industries
  • CostFlex’s Pre-Billing Charge Error Auditor was built with medical billing in mind, leading to more accurate results

It Requires Minimal Maintenance

  • Operates efficiently without major staff attention
  • Audit tool runs daily so that no patient’s bill slips through the cracks
  • Freely add additional audits through the user interface

3. Hospital Price Transparency

Transparency of pricing is a big deal, but it can be complicated. In order to help bring hospitals in line with government mandates and avoid regulatory fines, CostFlex has consulted with existing clients to integrate a pricing transparency feature into our software. This is what it does:

  • Groups patients into one of 300 “shoppable services” using CostFlex’s Product classification tool
  • Uses a Payer Contract Analysis feature to compare those classified groups against the modeled contracts and find reimbursement amounts
  • Groups patients by shoppable services or by the relevant contract’s reimbursement amount
  • Easily exports this data to CostFlex, who will create an easy-to-read patient-facing form the hospital can use to display its rates

CostFlex continues to support its customers after purchase. Within eight weeks, CostFlex will manage your installation process and train your staff to use our tools and user interface. After that, the software does most of the heavy lifting – and our expert CostFlex technical support staff is ready and able to help you navigate any obstacles if they arise.

Revenue cycle management software is a necessity for any hospital. Don’t settle for a generic option. Choosing CostFlex ensures you’ll stay ahead of the game with the best profit margins possible.

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