PAINS

   Low enrollment
   Broker management issues
   Low customer retention
   Inaccurate reporting
   Quoting and underwriting delays
   Marketing campaign issues
   Competitor tracking
   Low productivity
   Increasing claims costs
   Increased expenses
   Billing issues
   Profit losses
   Merger difficulties
   Multiple offices and branches
   Internal communications
   Excessive paperwork
   Decrease in service quality
   Other

PAIN DESCRIPTION:

Your billing practices — one of your organization's most complex, big-dollar operations — are likely to be your Achilles' heel, since billing errors have been the basis for most of the multi-million-dollar settlements paid by health care organizations recently. Your customers might have numerous complaints: about billing errors, not receiving itemized bills, billing practices, etc. How can you minimize the number of these complaints and avoid some of the billing errors? You have to scrutinize and tighten each step of your billing process to reduce potentially fraudulent claims.

PAIN ANALYSIS:

A Managed Care Organization wanting to boost its financial health might start by making sure claims are paid quickly. A recent report shows that the more quickly claims are paid, the more likely the MCO is to be financially healthy. That is because "aged receivables" cost MCOs lost interest and could become bad debt if left unchecked.

The average length of the group's accounts receivable is 43 days. The longer a claim stays in the receivable column, the more difficult it becomes to track and collect. The shorter HMOZ turnaround helped drive most Health Plans' net collections up 19 percent on a gross revenue gain of 23 percent. These accomplishments did not happen overnight. Health Care Organizations had to dedicate themselves to working as a team to reach their goals, a process that did not always come naturally. As MCOs grow, different departments become almost isolated from one another. What is more difficult than getting multiple disjoint departments to agree on an issue?

ADVICE:

HMOZ provides a single source to store vital information like billing addresses or contact details, which minimizes the probability of errors and billing delays. Standardized purged mailing, verified addresses, reduced cost of mailing and collection, proper integration with accounting systems, and links to primary contacts are among other benefits HMOZ gives to your Health Plan to optimize your billing processes.

One Demo is better than a thousand words, and one Solution Audit is better than a thousand demos. We encourage you to follow our CRM proverb and take advantage of this opportunity.

Click on one of the three links below to continue your HMOZ research.