Apollo Health Street launches two service lines to expand hospital revenue cycle management solutions

Jan 9 2010

Apollo Health Street, a developer of world-class solutions that tackle healthcare’s toughest financial and IT challenges, is expanding their hospital revenue cycle management solutions by launching two service lines to help providers recover revenue they are due from denied and zero balance claims.

“In a given year, up to 30 percent of the dollars a hospital is owed don’t reach the provider because a claim is denied by an insurance company, and 15 percent of those claims are never resubmitted”

The two service lines – Denials Management and Zero Balance Recovery – are based on two core goals: recover revenue that has not yet been received and identify root causes of denied or unfiled claims throughout the provider’s entire revenue cycle to curb future errors.

Paying particular attention to claims processing issues including medical necessity denial claims and retrospective audits, both Denials Management and Zero Balance Recovery aim to fix issues at the source to reduce denials in the future. These services are part of Apollo’s comprehensive set of business solutions that range from targeted, customized fixes for a piece of the revenue cycle to end-to-end outsourcing of the entire revenue cycle.

“In a given year, up to 30 percent of the dollars a hospital is owed don’t reach the provider because a claim is denied by an insurance company, and 15 percent of those claims are never resubmitted,” says Bill Colgan, senior vice president for hospital services at Apollo Health Street.

“Providers need a reliable, cost-effective and quick partner to overturn denials, recover revenue and institute improvements so that these issues become a thing of the past. Developing Denials Management and Zero Balance Recovery is a natural evolution of Apollo’s mission to help the nation’s providers achieve a strong bottom line that supports advancing patient care.”

Details of the service lines include:

- Denials Management: Apollo’s Denials Management service utilizes healthcare experts to develop a tailored strategy that assesses denial details, determines next steps needed to resolve the claim and creates a compelling appeal package for review by the payer. From the initial evaluation of a provider’s overall processes and a specific denied claim through an extensive follow-up process that confirms final determination for these claims, the service uses proprietary technology to seamlessly work through each piece of a specific claim while also analyzing root causes. The final step in the process is to implement changes that fix the root cause so that future claims are processed accurately, quickly and comprehensively. For more information, visit http://www.apollohealthstreet.com/denials-management.

- Zero Balance Recovery: Picking up where the typical Accounts Receivable Management cycle leaves off, Apollo’s Zero Balance Recovery identifies errors in charge capture, in claims processing and in adjudication in cases where less revenue was collected than expected. These situations are usually the result of incorrect adjustments or in cases where a claim was completely written off. Apollo’s team of experts works quickly to implement a plan so that a strong ROI is realized within, on average, 90 days. For more information, visit http://www.apollohealthstreet.com/zero-balance-recovery.

Apollo’s Denials Management and Zero Balance Recovery utilize customized and proprietary software developed by Apollo’s healthcare and IT experts. Each service features detailed reporting of analysis, findings and claim resolution strategies so that providers have a roadmap for success.

“In a revenue cycle and accounts receivable process as complex as those that healthcare providers manage everyday, it’s common to inadvertently miss billing for a service altogether or for individual charges,” said Andrew DeVoe, chief executive officer of Apollo Health Street.

“Since so many issues can occur, providers need a targeted, tailored and cost-effective way to analyze their revenue cycle piece-by-piece, uncover errors in claims processing and fix them so that future reimbursements yield the total revenue due to the hospital. These services are a key part of recovering the toughest dollars out of a provider’s revenue cycle.”