Hospital
Hospital
Hospital billing is the backbone of a healthcare institution’s financial health, and managing it effectively is crucial for both operational efficiency and sustainable growth. At ARCDOTT, we offer specialized hospital billing solutions designed to handle the complexities of modern healthcare reimbursement. From navigating payer contracts and claim submissions to managing denials and ensuring compliance, we provide end-to-end services to optimize your revenue cycle, reduce administrative burdens, and enhance financial performance.
We bring unmatched expertise in hospital billing for both inpatient and outpatient services, addressing the specific challenges that come with multi-department, multi-specialty, and multi-location operations. Let ARCDOTT streamline your billing operations, ensuring faster reimbursements, improved cash flow, and better financial visibility.
End-to-End Billing Solutions for Hospitals
We offer an all-inclusive suite of hospital billing services designed to manage the entire revenue cycle, ensuring accuracy, compliance, and timely reimbursements:
- Inpatient and Outpatient Billing: ARCDOTT’s billing systems are tailored to handle the complexities of inpatient admissions, outpatient visits, and other specialized services. We process all charges efficiently, ensuring nothing is missed.
- Charge Capture: Accurate charge capture is vital for optimal reimbursement. Our solution ensures that all services provided, whether in emergency, inpatient, or outpatient settings, are accurately recorded and submitted for payment.
- Coding & Coding Audits: Our experienced team of certified coders ensures that every diagnosis, procedure, and treatment is coded accurately based on the latest ICD-10, CPT, and HCPCS codes, adhering to payer and regulatory requirements. We also conduct periodic coding audits to maintain high accuracy rates.
- Claims Submission and Tracking: We handle the end-to-end process of claims submission to payers, ensuring proper coding and documentation. Our system tracks each claim in real time, allowing for proactive follow-up and management of any issues.
Automated Claims Management with AI-Driven Solutions
Efficiency is key to hospital billing success, and automation helps speed up the process while reducing errors. ARCDOTT integrates AI-powered tools to optimize claims management:
- Rapid Automated Processing (RAP): Our AI-driven RAP technology ensures faster claim submission, reduces errors, and expedites the reimbursement cycle by automatically processing claims for coding compliance and payer guidelines.
- Automated Denial Management: When claims are denied, we use AI to instantly identify the cause and automatically initiate the re-submission or correction process. This reduces human intervention and accelerates claim resolution, minimizing revenue loss.
- Predictive Analytics for Claim Trends: Using machine learning, our system analyzes historical claims data to predict which claims are more likely to face denials, enabling proactive adjustments to improve approval rates.
Multi-Department & Multi-Specialty Billing for Large Hospitals
Managing billing across diverse specialties and departments is one of the biggest challenges faced by large hospitals. ARCDOTT offers specialized solutions to handle billing complexities for multi-specialty and multi-departmental operations:
- Department-Specific Billing Solutions: Tailor billing systems for each department (e.g., cardiology, radiology, orthopedics, etc.), ensuring that specific workflows and requirements for each department are accounted for.
- Multi-Specialty Coordination: In hospitals with multiple specialties, we ensure each specialty’s billing is handled according to its unique protocols and reimbursement rules. This minimizes errors and ensures compliance across different providers and specialties.
- Integrated Billing System Across Locations: For hospitals with multiple locations, our integrated system consolidates billing data from each site into a single platform, allowing for streamlined operations and centralized management.
Payer Contracting & Compliance Management
One of the critical components of hospital billing is ensuring proper reimbursement in line with payer contracts and regulatory standards. ARCDOTT offers expertise in payer contract management and compliance:
- Payer Contract Negotiation & Management: We help you navigate the complexities of payer agreements, ensuring your contracts are optimized for favorable reimbursement rates and terms. We also monitor payer performance to ensure adherence to contract terms.
- Regulatory Compliance: We ensure your billing practices comply with the latest government regulations (e.g., CMS, HIPAA, HITECH) and insurance industry standards, reducing the risk of audits and penalties. Our team stays updated with regulatory changes, ensuring your hospital remains compliant.
- Billing Code Updates & Audit Preparation: We monitor and implement updates to coding systems like ICD-10, CPT, and HCPCS to ensure your hospital stays compliant with the latest billing standards. We also help you prepare for external audits by ensuring accurate documentation and coding practices.
Revenue Cycle Analytics, KPI Dashboards, and Financial Reporting
Hospital billing isn’t just about processing claims—it’s about continuously improving your financial health. ARCDOTT’s advanced analytics tools provide real-time insights into your hospital’s revenue cycle:
- Revenue Cycle Performance Analytics: Track key metrics such as claim acceptance rates, rejection rates, time-to-payment, and aging accounts receivable (AR). Our analytics give you visibility into the entire cycle, enabling proactive decision-making.
- Customizable KPI Dashboards: Create personalized dashboards that track key performance indicators (KPIs) relevant to your hospital’s revenue cycle. Metrics such as payer performance, coding accuracy, and departmental revenue can be easily monitored in real time.
- Location & Department-Specific Reports: For hospitals with multiple locations or departments, ARCDOTT provides detailed, location-specific or department-specific financial reports, allowing you to drill down into the performance of each area and identify areas for improvement.
- Trend Analysis and Predictive Reporting: Use predictive analytics to identify emerging trends, such as increasing denial rates or delayed payments, so you can adjust processes and mitigate financial risks.
Patient Billing & Financial Engagement
Ensuring patients understand their bills and can pay in a timely manner is vital for reducing collections and improving patient satisfaction. ARCDOTT’s patient billing solutions are designed to enhance the patient experience while accelerating payments:
- Clear and Transparent Billing Statements: Provide patients with easy-to-understand, itemized billing statements that clearly show charges, insurance payments, and any remaining balances.
- Flexible Payment Options: Offer payment plans and financing options for patients, allowing them to pay over time while reducing your hospital’s bad debt.
- Patient Portals & Online Payments: Give patients the ability to view their billing statements, make payments online, and communicate with the billing department through a secure, easy-to-use portal.
- Patient Communication & Engagement: We help enhance patient satisfaction by sending timely reminders for upcoming payments, overdue balances, and payment options.