Our Services

Navigating the complexities of the healthcare revenue cycle can be challenging. At We5, we offer end-to-end medical billing, coding, and accounts receivable management services to simplify this intricate process.

Streamlined Services and Advanced Automation Across the Revenue Cycle

We collaborate with healthcare organizations to enhance and expedite reimbursements, prevent denials, curb revenue leakage, and elevate the patient experience. Our innovative automation technologies ensure optimal revenue cycle performance. Trust We5’s best practices to achieve superior results.

Our partnership focuses on leveraging the latest technologies and industry best practices to refine and accelerate reimbursements, minimize denials, halt revenue leakage, and ultimately enhance patient satisfaction. We are dedicated to optimizing your revenue cycle while cutting costs and increasing revenue.

Our services cover the entire revenue cycle, from front-end to back-end, including:

At We5, we are dedicated to achieving revenue cycle excellence through innovative automation technologies and best practices. Allow us to streamline your revenue cycle processes and drive improved financial outcomes.

Efficient scheduling and appointment management are crucial for providing high-quality healthcare. Properly capturing eligibility and prior authorization requirements, minimizing long hold times, and streamlining processes are essential to ensure patient satisfaction and maintain positive referrals from physicians.

Patient Scheduling

At We5, we recognize the significance of effective scheduling and appointment management in enhancing healthcare delivery. Our goal is to streamline the scheduling process, reduce no-shows, and boost patient engagement, ensuring optimal outcomes for both providers and patients.

Our Patient Scheduling and Appointment Management services are designed to assist healthcare providers in managing their schedules more effectively while enhancing patient satisfaction. Our comprehensive services include:

• Online Appointment Scheduling: Our intuitive online portal allows patients to schedule appointments at their convenience, eliminating long hold times and complex phone systems.
• Eligibility and Prior Authorization Collection: We collect necessary patient information to ensure that eligibility and prior authorization requirements are met before scheduling appointments.
• Provider Availability Scheduling: Our team schedules appointments based on provider availability, patient preferences, and location, ensuring a seamless experience for all parties involved.
• Direct Messaging System: Our messaging system facilitates direct communication between physicians and patients, making it easy to address questions, share important information, and maintain contact.
• Appointment Confirmation and Reminders: We send automatic appointment reminders and seek confirmation from patients to minimize no-shows and enhance appointment attendance.
• Automated Reminders: Our system sends automated reminders to both patients and providers, reducing the likelihood of missed appointments.

Benefits of Our Patient Scheduling and Appointment Management Services

• Reduced No-Shows: Automated reminders and appointment confirmations help decrease the number of missed appointments, improving revenue cycle performance.
• Enhanced Patient Engagement: Convenient scheduling options and direct communication with patients contribute to higher engagement and satisfaction.
• Optimized Physician Calendars: We efficiently match patients with available providers, optimizing physician schedules and reducing wait times.
• Real-Time Dashboard for Physicians: Physicians can access a real-time dashboard to view and manage their schedules, ensuring effective time management and patient care.
• Automated Reminders and Follow-Ups: Our system automatically sends reminders and follow-ups, ensuring that appointments are attended and payments are processed on time.
• Comprehensive Payment Tracking: We track patient payment history and outstanding payments, simplifying billing and collections management.

At We5, we understand that effective scheduling and appointment management are vital to delivering high-quality healthcare services. Our services are designed to streamline your operations, reduce no-shows, and enhance patient engagement.

Contact Us: Today to discover how We5’s Patient Scheduling and Appointment Management services can benefit your organization.

FAQs about Our Patient Scheduling and Appointment Management Services

At We5, we recognize that accurate and thorough eligibility and benefits verification is essential for providers to deliver timely and appropriate care. Our Eligibility and Benefits Verification Services are designed to support healthcare providers in making informed decisions regarding patient care, medications, and diagnostics—particularly for elective and non-emergency procedures—based on the patient’s insurance coverage.

Without proper verification processes, providers may face significant revenue losses due to denials and delayed payments. To mitigate these risks, we provide comprehensive insights into patient eligibility before the actual encounter. This enables healthcare providers to recommend treatments aligned with coverage parameters, understand out-of-network benefits, and manage payment responsibilities effectively.

Our team of experts excels in verifying patient eligibility by checking coverage details through payer websites and making necessary phone calls. We ensure a standardized, efficient verification process with quick turnaround times.

Eligibility and Benefits Verification Services at We5

Our Eligibility and Benefits Verification Services offer the following advantages:

• Flexible Workflow Integration: Receive verification requests through various patient scheduling systems, including EDI, fax, email, and FTP files.
• Comprehensive Coverage Verification: Rapid and accurate confirmation of primary and secondary coverage details, including member ID, group ID, coverage period, co-pay, deductible, co-insurance, and benefits information.
• Efficient Payer Communication: Connect with payers through the most effective channels to ensure accurate and timely information.
• Data Accuracy and Resolution: Quickly identify and resolve missing or invalid data to ensure complete and accurate patient information.
• Robotic Process Automation: Utilize advanced automation technologies to enhance speed and precision in the verification process.
• Detailed Verification: Confirm patient demographic and policy information, including benefits, deductibles, plan inclusions, and exclusions.
• Pre-Certification and Approval: Obtain pre-certification numbers and secure approvals for benefits verification.
• Up-to-Date Information: Verify coverage, co-pays, co-insurance, deductibles, and claims mailing addresses with all primary and secondary payers, and update the revenue cycle management system accordingly.

We5’s Value Proposition for Eligibility Verification Services

Our Eligibility Verification Services provide the following key benefits:

• Optimized Revenue and Cash Flow: Enhance financial performance by reducing denials and ensuring accurate billing.
• Minimized Denials: Decrease the number of denials related to patient information inaccuracies.
• Cost Savings: Benefit from global delivery models that offer significant cost advantages.
• Data Accuracy Assurance: Receive accurate and complete patient information for better decision-making.
• Reduced Rejections: Lower the frequency of rejections due to information issues.
• Clear Patient Responsibility: Gain upfront clarity on patient financial responsibilities, improving financial management.
• Enhanced Patient Satisfaction: Provide a smoother experience for patients by addressing eligibility concerns promptly.
• Improved Quality: Elevate the quality of service delivery with precise and timely eligibility verification.

Contact Us: today to discover how We5’s Eligibility and Benefits Verification Services can enhance your organization’s efficiency and financial performance.

Prior authorization is a critical component of the healthcare revenue cycle, offering vital protection for both healthcare providers and their patients. It ensures that services, medications, and procedures comply with payer guidelines and coverage requirements, safeguarding against substantial financial liabilities and revenue losses. Adhering to these guidelines is especially crucial for complex or costly treatments, except in emergency situations.

Healthcare providers are dedicated to delivering the best possible care while navigating payer guidelines to select appropriate treatment plans. To achieve optimal outcomes, providers must secure prior authorization for diagnostics, medications, or procedures, confirming that the patient’s coverage includes these services. Providers may also recommend alternative treatments within the scope of the patient’s coverage to ensure financial and clinical success. By clarifying these aspects, providers can enhance patient satisfaction and avoid potential financial pitfalls.

At We5, we offer specialized Prior Authorization services designed to streamline the revenue cycle and enhance collection efficiency. We partner with leading solution providers to minimize manual effort, improve quality, and accelerate turnaround times.

Prior Authorization Services at We5

Our Prior Authorization Services include:

• Comprehensive Policy Analysis: Thorough examination of payer policies to assess coverage requirements for each patient.
• Rapid Determination of Requirements: Efficient identification of prior authorization needs for timely processing.
• Accurate Documentation: Precise preparation and submission of paperwork to ensure compliance with payer requirements.
• Persistent Follow-Ups: Diligent tracking of submitted requests to address any issues or ambiguities promptly.
• Immediate Provider Notifications: Quick communication to providers regarding any authorization problems or clarifications needed.

We5’s Value Proposition for Prior Authorization Services

Our Prior Authorization Services offer several key benefits:

• Clear Coverage Options: Provides clarity on available options under coverage rules, aiding in informed decision-making.
• Educated Treatment Choices: Assists in selecting alternatives aligned with patient coverage, avoiding unnecessary delays or denials.
• Denial Prevention: Reduces the risk of denials related to coverage issues through thorough and timely processing.
• Enhanced Patient Awareness: Improves patient understanding and satisfaction by ensuring that they are informed about their coverage and options.

Contact Us: today to learn how We5’s Prior Authorization Services can enhance your organization’s efficiency and financial performance.

Accurate patient registration and demographic data capture are crucial for the success of your revenue cycle and essential for effective population health analytics. Ensuring complete and precise information at the point of service helps avoid claim denials and delays, ultimately safeguarding your revenue and improving operational efficiency.

Research indicates that healthcare organizations can lose up to 7% of their annual revenue due to errors in demographic data capture. Implementing a clear, standardized process for collecting and managing patient demographic information helps prevent critical mistakes and enhances the accuracy of claim submissions. This, in turn, reduces payment delays and denials, ensuring a smoother revenue cycle.

We5’s Patient Registration Services

Our Patient Registration Services are designed to enhance accuracy and optimize your revenue cycle through meticulous demographic data management. Our services include:

• Demographic Entry and Verification: We validate and update essential patient information in your practice management system, including:
  • Legal name, gender, address, and phone numbers (work/home/mobile)
  • Social Security numbers for identification
  • Health insurance information and policy details
  • Medicaid or Medicare policy details
  • Contact information for the person responsible for payments
  • Special requirements (e.g., interpreter services, stretcher access)

What to Expect with We5’s Patient Registration Services?

Partner with We5 and benefit from our expertise in revenue cycle management. Our dedicated team of process experts is committed to understanding your organization’s functions thoroughly, ensuring total efficiency and accuracy. Here’s what you can expect:

• Enhanced Accuracy and Productivity: Our team ensures improved accuracy in capturing patient demographic information, leading to more reliable data management.
• Increased Clean Claim Submissions: Accurate demographic data contributes to a higher rate of clean claim submissions, minimizing rejections and delays.
• Reduced Denials: By addressing demographic errors proactively, we help decrease the number of denials related to patient information.
• Real-Time Collaboration and Reporting: Access our client portals for real-time collaboration, detailed status updates, and reporting on a weekly basis.

Contact Us: today to discover how We5’s Patient Registration and Demographics Services can enhance your revenue cycle management and improve overall operational efficiency.

Effective documentation and accurate charge entry are critical to preventing revenue leakage, which can result in significant financial losses. Implementing robust charge capture workflows and fostering effective collaboration between coding and charge entry teams are essential for reducing lost revenue and improving the overall revenue cycle process.

We5’s charge entry experts, equipped with deep expertise in multiple specialties and revenue cycle platforms, handle a high volume of charge transactions with exceptional precision. Our client portal facilitates seamless communication and collaboration, ensuring a smooth end-to-end process.

Charge Capture

Our charge entry process is designed to maintain consistency and accuracy:

• Document Reception: Receive documents such as superbills, charge tickets, and source documents through FTP, document management systems, or directly from the client’s system.
• Data Capture: Accurately record the date of service, billing provider, referring provider, place of service (POS), admission date, CPT/procedure codes, ICD-10 codes, number of units, and modifiers.
• Real-Time Reporting: Utilize our proprietary tool, ARC.flow, for real-time reporting and escalation of pending issues, resulting in quicker turnaround times and enhanced accuracy.
• EMR Integration: Import charges directly from the EMR system, with a thorough review for accuracy before submission for billing.

Charge Audit

We5’s Charge Audit services are designed to uncover missed charges, over-billing, and coding errors that can lead to revenue loss. Our analytical approach includes:

• Order Validation: Ensure written orders align with the level of care and all treatments rendered.
• Modifier and Unit Accuracy: Verify that necessary modifiers are applied and the exact number of units billed.
• Charge Comparison: Compare charges across patient accounts to identify discrepancies.
• Fee Schedule Verification: Cross-check charges against updated fee schedules.
• Error Detection: Identify undercharges, duplicate postings, and overcharges.
• Department Coordination: Verify charges with various department billers and coders to ensure consistency.

Charge Audits help diagnose issues such as problems with charge entry, provider absences, delayed charge reporting, changes in coding patterns, unbilled services, and other causes of claim denials. Ideally, charge consistency should be maintained from month to month, barring any changes in physician availability or productivity.

We5’s Value Proposition for Charge Entry and Charge Audit Services

Our Charge Entry and Charge Audit services offer the following benefits:

• Enhanced Productivity and Accuracy: Improve efficiency and precision in charge entry and processing.
• Specialty Competency: Leverage our expertise across various specialties to ensure accurate charge management.
• Timely Claims Filing: Ensure timely submission of claims and benchmark fee schedules and denial patterns.
• Revenue Leakage Mitigation: Review charge entry processes to prevent revenue leakage through thorough audits.
• Appropriate Reimbursement: Ensure correct reimbursement is collected and compliance issues are addressed.
• Lost Charge Recovery: Recover lost charges and minimize delays in accounts receivable processing.
• Real-Time Collaboration and Reporting: Access real-time reporting and collaboration through our client portals.

Contact Us: today to learn how We5’s Charge Entry and Charge Audit services can enhance your revenue cycle management and improve financial performance.

Are you facing challenges with accuracy scores and turnaround times in your medical coding process? Accurate and efficient medical coding is crucial for a smooth healthcare revenue cycle. Subpar performance in these areas can impact your bottom line. We5 offers expert coding solutions to optimize your revenue cycle and enhance financial outcomes.

We5’s Global Coding Platform

Medical coding, while essential, can be complex and overwhelming due to evolving ICD-10 requirements and payer trends. With We5’s Coding and Auditing services, you can streamline your revenue cycle and ensure efficient, accurate coding.

• Ensure ICD-10 Compliance: Stay up-to-date with ICD-10 standards to avoid compliance issues and denials.
• Reduce AR Backlogs: Improve your accounts receivable management by reducing backlogs and speeding up claim processing.
• Decrease DNFB: Minimize the number of days in Accounts Receivable (DNFB) to accelerate cash flow.
• Enhance Quality of Care: Improve the accuracy of documentation, leading to better patient care and outcomes.
• Improve Provider Documentation: Support providers in accurate and comprehensive documentation practices.
• Reduce Turnaround Times: Speed up the coding process to enhance overall efficiency.
• Reliable Data Reporting: Benefit from consistent and accurate data reporting for better decision-making.

Process and Technology

Rest assured knowing that We5 provides a highly skilled team, following a proven process and utilizing cutting-edge technology. It's like having your own coding department without the associated expenses and complexities.

Training Methodology and Audits

Attracting and retaining experienced coders can be challenging. Partnering with We5 means gaining access to a team of seasoned coders without the lengthy hiring process. Each coder is rigorously vetted, trained, and tested weekly, with built-in audits to ensure accuracy throughout the process.

• We5’s Coding Training: Our training program is designed to keep our coders at the forefront of industry standards and best practices.

Best Practices

Transform your revenue cycle management with We5’s proven methods. We provide regular updates and expert suggestions for continuous improvement, ensuring that coding practices align with the broader revenue cycle management strategy.

Technology

Utilize our proprietary platform, arc.in, to gain unparalleled visibility and oversight. Track productivity, monitor auditing scores, and see exactly who is working on your account and what tasks they are handling. The arc.in platform ensures 100% transparency and peace of mind.

Elevate Your Back-Office Revenue Cycle Management

Focus more on delivering exceptional patient experiences and less on revenue cycle concerns. Implement We5’s back-office solutions across your RCM disciplines to unlock new value and optimize your revenue cycle.

Contact Us: today to learn more about how We5’s Medical Coding Services can enhance your revenue cycle management and financial performance.

Clear, consistent, and accurate clinical documentation is essential for high-quality healthcare. It enhances patient care, supports effective communication, and minimizes claim denials. However, achieving these goals can be challenging when your care team faces difficulties with the documentation process.

We5’s Clinical Documentation Improvement (CDI) services are designed to meet the unique needs of your health system. Our skilled professionals, passionate about improving documentation quality, are experienced in reviewing and enhancing medical records. By partnering with us, you can boost your CDI program's performance and ROI while enjoying a range of benefits:

• Offsite or Onsite
• Global or Domestic
• Flexible Staffing Models
• Improved ROI
• DRG Maximization
• DRG Maximization
• Enhanced ICD-10 Code Assignment
• Increased Physician Communication
• Improved Clinical Performance

Why Enhance Your CDI Program with We5?

Outsourcing a portion of your CDI program is a significant decision, especially when it impacts clinical outcomes and physician processes. At We5, we offer a flexible approach to ensure that your needs are met while supporting your staff, patients, and community.

Flexibility in Staffing

Our CDI services can be customized to fit your organization’s needs. Whether you prefer an onsite, offsite, global, or domestic solution—or a combination of these—we offer the flexibility to create a CDI program that aligns with your goals.

• Global CDI Services: Our global CDI services provide a cost-effective solution with 24/7 support. Specialists at our global delivery center are highly trained, continuously educated, and undergo regular audits to ensure top performance.

Increased Communication

Effective communication is crucial for successful CDI. Ensuring that all team members adhere to best practices and clearly document encounters requires a structured communication strategy. We help establish the right communication patterns to keep CDI practices at the forefront and align everyone towards the goal of improved documentation.

Improve ROI

Enhanced clinical documentation directly impacts ROI. Accurate and thorough documentation ensures that your organization is properly reimbursed for the services provided. Improved documentation also streamlines coding efforts, reducing errors and the time coders spend interpreting documentation.

CDI vs. Coding

A CDI specialist focuses on ensuring that physicians' documentation is complete and accurate. While coders assign codes based on documentation, a well-functioning CDI program reduces the likelihood of errors being detected at the coding stage. This collaboration ensures comprehensive and precise documentation.

How CDI Helps Your Community?

Accurate documentation can enhance the quality of data sent to the CDC and other agencies, potentially increasing your chances of securing grants and funding. Furthermore, precise documentation improves care decisions for patients, both during their stay and for future care needs, ultimately benefiting the community.

Contact Us: today to learn how We5’s Clinical Documentation Improvement Services can elevate your documentation practices and improve your revenue cycle management.

Bring Excellence to Your Back Office Revenue Cycle Management

Ensure your coding department is optimized for efficiency and accuracy with We5’s comprehensive Medical Coding Audit and Education Services. Our services are designed to minimize revenue leakage, enhance coding accuracy, and address specific coding issues related to physicians, facilities, or specialties. The insights from our audits drive improvements in clinical documentation and help your coding team work effectively with physicians to enhance accuracy and reduce claim denials.

Enhance Your Coding Accuracy

Medical Coding Audits Our audit services focus on:

• Identifying Billing Gaps: Detect discharges that may not have been fully billed to prevent revenue loss.
• Improving Coding Accuracy: Pinpoint errors and inconsistencies in coding to ensure accurate claims and reimbursements.
• Addressing Specific Issues: Identify and address coding issues specific to physicians, facilities, or specialties.
• Driving Improvement Initiatives: Use audit findings to guide clinical documentation improvement efforts and reduce denial rates.

Customizable Education Services Benefit from tailored educational programs designed to address your organization’s unique challenges. Learn from highly skilled coding specialists in either group sessions or one-on-one settings.

Key Features of Our Services:

Coding Excellence In the era of ICD-10 and evolving regulations, aim for more than just compliance—strive for coding excellence. We5’s customizable audit and education services are crafted to meet your specific needs.

Built to Suit Whether you need a one-time audit, ongoing oversight, or a detailed examination of specific problem areas, we develop solutions tailored to your organization. If the audit reveals areas needing further education, we provide customized training programs to address those needs effectively.

Process Improvement Our audits are conducted by expert coding specialists who are proficient in specific service lines and backed by a comprehensive end-to-end revenue cycle management system. We identify and resolve issues throughout the revenue cycle that contribute to coding inaccuracies and revenue loss.

Analytics Leverage We5’s advanced analytics technology to visualize and assess the success of your coding department. Our arc.in platform provides detailed reporting, in-depth analysis of specific areas, and random sampling to gauge overall performance.

We5 Code Audit Process

Contact Us: today to discover how We5’s Medical Coding Audit and Education Services can optimize your coding practices, enhance accuracy, and boost your revenue cycle management.

Bring Excellence to Your Coding Department

Healthcare systems and hospitals face significant revenue leakage, with losses ranging from 4-5% of their total revenue. As a hospital executive, it is crucial to focus on maximizing net revenue, enhancing coding accuracy, and ensuring compliance to create a scalable, error-free revenue cycle process. Neglecting small revenue leaks can result in substantial financial loss and put your organization at risk. Shockingly, up to 60% of health systems lack a formalized revenue integrity program.

Key Sources of Revenue Leakage:

• Coding Issues: Unbilled procedures and errors in coding contributing to high Discharges Not Fully Billed (DNFB) rates.
• UB-04 Form Errors: With 81 fields and multiple subcategories, errors are common in claims submitted.
• Charge Description Master (CDM) Setup Issues: Inaccuracies in CDM files.
• Inadequate Staff Training: Lack of knowledge about revenue leakage causes and clinical documentation.
• Unstructured Revenue Integrity Programs: Absence of a data-driven approach and structured programs.
• Payer Contracting Issues: Ineffective payer contracting processes.

Explore Our Suite of Revenue Integrity Services and Solutions

Structured Revenue Integrity Program

• Comprehensive Audits: Identify and address key sources of revenue leakage.
• Enhanced Coding Accuracy: Improve clinical documentation and reduce DNFB.
• Quality Assurance: Apply processes and methods to enhance compliance.
• Analytics Expertise: Utilize data to pinpoint issues and implement sustainable solutions.

Obtain Prior Authorizations

• Optimize Authorizations: Technology-enabled precertification and authorization services for inpatient and outpatient services.

Clinical Documentation Improvement (CDI)

• Documentation Quality: Improve the accuracy of clinical documentation.
• Trends and Gaps: Identify specific diagnosis/procedure trends and gaps.
• Clinician Sensitization: Address issues in clinical documentation and foster ongoing dialogue.

Charge Capture Audit Services

• Missed Charges: Review bills to identify missed chargeable opportunities.
• Audit Review: Comprehensive analysis of procedures, documentation, and billing processes.
• Efficiency Strategy: Develop sustainable strategies to improve charge capture by collaborating with billers, coders, and clinicians.

HIM Coding Review and Coding Staffing

• Coding Staffing: Deploy skilled coders for backlog clearance, system transitions, and regulatory reporting.
• Coding Reviews: Audit claims for correct usage of CPT, HCPCS codes, and DRGs.
• Coding Education: Verify accuracy, address compliance issues, and provide targeted coding education.

Payment Variance Analysis

• Claim Analysis: Analyze denied and underpaid claims to manage appeals and ensure correct reimbursement.
• Root Cause Analysis: Address underlying issues in the front office and mid-revenue cycle.

Contact Us: Learn how We5 can help your organization ensure revenue integrity and enhance financial performance. Plug the leakage with We5’s Revenue Integrity team today!

While coding and clinical documentation are often seen as the core components of effective medical billing, remittance processing plays a crucial role in the overall revenue cycle. We5 healthcare’s remittance processing team does more than just post payments—we provide valuable insights into your revenue cycle’s effectiveness, including trends in denials, prior authorizations, non-covered services, and the quality of your clinical documentation and coding processes.

Our Remittance Processing Capabilities:

• Electronic Remittance Advisory (ERA) Posting: We handle high-volume ERA batches with precision. This involves loading files into the revenue cycle system, addressing exceptions, and making necessary corrections using available system functionalities.
• Manual Payment Posting: We capture payment information from scanned Explanation of Benefit (EOB) documents and accurately post each line item to the respective patient accounts. By developing tailored business rules, we ensure precise payments, adjustments, write-offs, and balance transfers.
• Denial Posting: Our team is proficient in handling ANSI denial codes and payer-specific remark codes. We manage denial postings, take necessary actions such as billing secondary payers or transferring balances to patient accounts, and route denied claims to appropriate work queues.
• Patient Payment Posting: We process payments received from patients via various channels—POS cash collections, checks, and credit cards. Our team ensures proper account reconciliation, handles pending balances, and resolves credit issues effectively.

Automated Tools for Payment Posting:

• Intelligent Payment Processing Platform: Our OCR-enabled platform reads printed EOBs in each payment batch, presenting transactions in a tabular format for efficient processing. It interfaces seamlessly with any third-party revenue cycle platform, enhancing accuracy and speed.

We5 healthcare’s Value Proposition for Payment Posting Services:

• Analytics: We provide detailed production and quality reports, offering insights into denial trends, non-covered services, prior authorization issues, and point-of-service collections.
• Policy Development: We assist in creating and implementing clear policies for write-offs and adjustments, and report unusual contractual adjustments during payment processing.
• Denial Handling: Denied claims are routed to the coding and denial management teams for timely rework and re-submission to payers.
• Secondary Payer Claims: We identify claims with secondary payers and manage the processing of remaining balances.
• Knowledge Management: Our knowledge management tool, .Knol, helps track updates and maintain organized business and process rules, ensuring effective service delivery.
• Dashboards: Our dashboards provide real-time access to process health indicators, enabling continuous improvement and efficiency.

Contact Us: Learn more about how We5 healthcare’s Remittance Processing Services can optimize your revenue cycle management and improve financial performance.

Maximize your revenue and reduce unpaid debt with We5 healthcare’s expert Accounts Receivable (AR) Services. Our time-tested best practices and proven processes are designed to enhance your collection efforts and minimize AR backlogs, ensuring that more money is collected, and faster.

Why Choose We5 healthcare for AR Services?

• Expertise and Results: Our dedicated team understands the unique needs of medical billing companies, hospitals, and healthcare systems. We work tirelessly to exceed your AR goals, focusing on both immediate results and long-term improvements.
• Customer Satisfaction to Customer Delight: We aim for more than just satisfaction. Our goal is to delight you by enhancing your revenue cycle end-to-end. We identify the root causes of AR backlogs, addressing problems proactively rather than merely treating symptoms.

Our AR Services Include:

• Best Practices: We analyze your current AR processes to pinpoint areas for improvement. By applying best practices and continuously challenging the status quo, we help you achieve more efficient collections and reduce AR backlogs.
• Holistic Approach: A well-oiled revenue cycle starts with a holistic approach. We identify and correct errors in your revenue cycle processes that contribute to AR backlogs, tackling issues before they escalate.
• Advanced Technology: Our proprietary arc.in workflow management system provides unmatched transparency and oversight. It facilitates seamless collaboration between teams with real-time reports and status updates, allowing you to gauge productivity and resolve issues efficiently.

Proven Success:

• Track Record: One of our clients captured over $10 million in AR by implementing We5 healthcare’s best practices. Let us help you achieve similar success.

Contact Us: Learn more about how We5 healthcare’s Accounts Receivable Services can transform your revenue cycle management and improve your financial performance.

In a healthcare revenue cycle where insurance companies deny an average of 9% of claims, effective Denial Management is crucial for maintaining healthy cash flow. Handling claim denials efficiently not only ensures timely payments but also improves your overall revenue cycle management.

Why Denial Management Matters?

Dealing with claim denials can be time-consuming and divert focus from patient care. Effective denial management is essential to ensure that your organization gets paid for the services provided. We5 healthcare specializes in identifying the root causes of denials, mitigating future risks, and accelerating payment collection.

Download our Denial Management Brochure for more details.

Focus on What Matters

Your primary goal is to improve patient outcomes, not to navigate complex insurance claim processes. With We5 healthcare’s systematic best practices and proven methodologies, we streamline your denial management process, providing valuable insights and helping you get paid faster.

Our Denial Management Approach

• Systematic, Hands-On Resolution: Each claim denial is unique, and our approach reflects this. We apply a systematic, hands-on strategy to resolve claims efficiently, adhering to defined best practices for optimal results.
• A/R and Denial Analysis: Our team thoroughly analyzes and researches each denied claim to determine the best resolution path, ensuring a thorough and effective approach.
• Prioritized Workflow: We prioritize claims based on payer, amount, age of bill, and other business rules to maximize recovery and efficiency.
• Denial Prevention: By identifying and addressing the root causes of denials, we provide actionable suggestions for process improvements to prevent future issues and improve overall practice health.

Did You Know? 90% of claim denials are preventable. Stop leaving money on the table and optimize your denial management processes.

Success Story

Objective: Improve cash flow and simplify access to revenue. The organization needed to identify inefficiencies and enhance financial performance.

Solution: Within 30 days, We5 healthcare conducted a comprehensive assessment of the organization’s AR footprint. The assessment revealed substantial opportunities for improvement, leading to an estimated $10 million in potential cash flow enhancements.

Contact Us: Learn how We5 healthcare’s Denial Management Services can help your organization resolve claim denials, prevent future issues, and improve financial performance.

Credit balances can become a liability on your balance sheet, consuming valuable time and resources that could be better spent enhancing patient care. Let We5 healthcare handle your credit balance issues efficiently, so you can focus on what matters most: delivering exceptional patient experiences.

Download our Credit Balance Flyer for more information.

Why Focus on Credit Balances?

Handling credit balances might seem like a minor task compared to patient care, but it’s a crucial aspect of maintaining a smooth revenue cycle. Efficiently managing these balances not only ensures compliance but also strengthens relationships with patients and insurance companies.

The Right Approach

Credit balances are often a sign of underlying issues in your billing process. Instead of just addressing the symptoms, We5 healthcare takes a comprehensive approach to identify and correct the root causes, preventing future occurrences.

• Customer Satisfaction: Efficient and professional credit balance management is key to maintaining positive relationships with patients, insurers, and other payers. Our proven best practices ensure that your customers remain satisfied and confident in your billing processes.
• Constant Improvement: We don’t just resolve credit balance issues; we analyze and improve the underlying processes that lead to them. By diagnosing the root causes, we help prevent similar issues from recurring.
• Advanced Technology: Our arc.in workflow management system provides unparalleled transparency and oversight. It allows for real-time reporting and status updates, facilitating seamless collaboration between teams to resolve credit balance issues swiftly.

Bring Excellence to Your Revenue Cycle Management

By leveraging We5 healthcare’s Credit Balance Services, you can reduce administrative burdens and enhance the overall patient experience. Let us manage the complexities of credit balances while you focus on delivering top-notch care.

Contact Us: Discover how We5 healthcare can streamline your credit balance management and improve your revenue cycle. Talk to our team today!

Medical Billing Specialists play a crucial role in optimizing the revenue cycle for healthcare organizations. Ensure your organization operates at peak efficiency by connecting with the best Medical Billing Specialists through We5 healthcare.

Download our Billing Specialist Brochure for more information.

Achieve Excellence in Your Revenue Cycle

We5 healthcare’s Billing Specialist model serves as your dedicated partner in managing all account activity, identifying trends, and addressing unresolved accounts receivable (AR). Our specialists are committed to:

• Improved Collections: Increase your revenue by ensuring timely and accurate billing processes.
• Reduction in Unresolved & Old AR: Minimize outstanding and aged accounts with targeted follow-ups and management.
• Reduction in AR Days: Shorten the time it takes to collect payments.
• Quicker Turnaround Time: Expedite claims processing and payment collection.
• Higher Return on Investment: Achieve greater financial returns through efficient billing practices.
• Reduced Costs: Lower operational costs associated with in-house billing.

What to Expect?

Partnering with We5 healthcare means having a reliable team of Billing Specialists who understand the intricacies of revenue cycle management. Here’s what you can expect:

• Comprehensive Account Management: Our specialists handle the entire payment lifecycle, including collecting, posting, and managing account payments, submitting claims, and following up with insurance companies to ensure timely payments.
• Detailed Reporting: Receive regular status updates and detailed weekly reports that keep you informed of account activity and trends.
• Proactive AR Management: We review account information to spot trends, optimize revenue cycle processes, and address unresolved AR, claim denials, and coding issues. Root causes are identified and communicated for resolution.
• Client Liaison: Our Billing Specialists act as intermediaries between your organization and insurance companies, ensuring smooth communication and efficient resolution of issues.

Best Practices

Leverage We5 healthcare’s best practices engine to elevate your revenue cycle management. Our Billing Specialists are highly trained in industry best practices and continuously focus on improving each step of the billing process.

Download our Billing Specialist Infographic to learn more about our best practices.

Contact Us: Discover how We5 healthcare's Medical Billing Specialists can enhance your revenue cycle management and streamline your billing processes. Contact us today to learn more.

Navigating the complex process of provider credentialing with payers involves numerous manual steps, including completing application forms, responding to payer inquiries, and following up to close the credentialing request. We5 healthcare simplifies and accelerates this process, ensuring your data remains current and compliant with payer requirements.

Download our Provider Credentialing Brochure for more information

Why Provider Credentialing Matters?

Provider credentialing is a crucial component of the revenue cycle, enabling patients to use their insurance for medical services and ensuring providers receive reimbursement. Efficient credentialing ensures that patients can access care at your practice and prevents them from seeking alternative providers who are already enrolled with their insurance plans.

Streamline Your Credentialing Process with We5 healthcare

Our Credentialing Process Includes:

• Application Evaluation: Complete required documentation and identify any exceptions.
• Primary Source Documentation: Verify practitioner or facility information from physicians.
• Outbound Call Center: Obtain missing documents and update the payer's database.
• Follow-up with Payers: Ensure submitted credentialing requests are processed and approved.
• Data Entry: Capture and link data to specific providers or facilities in the payer's database.
• Maintenance of Provider Data: Update provider information according to policies and procedures, including CAHQ profiles.

Provider Enrollment Services

Our Provider Enrollment services ensure that practices are properly enrolled with payers to facilitate claims processing and provider reimbursement. We monitor applications closely to ensure timely receipt and processing, proactively resolving potential issues before they impact reimbursements.

Our Enrollment Process Includes:

• Verification of Provider Information: Confirm correct provider details with payers before claim submission.
• Updating Pay-to Address: Validate and update the provider's pay-to or billing address.
• Enrolling for Electronic Transactions: Facilitate enrollment for electronic transactions, including:
  • Electronic Data Interchange (EDI)
  • Electronic Remittance Advice (ERA)
  • Electronic Fund Transfer (EFT)
  • Claims Status Inquiry (CSI)
• Monitoring Process: Conduct research and analysis to identify and address any processor functionality gaps.

Benefits of Our Credentialing and Enrollment Services:

• Keep Data Up-to-Date: Maintain accurate provider data with payers.
• Faster Payments: Accelerate payment processing from insurance and increase patient referrals.
• Mitigate Revenue Leakage: Reduce the risk of revenue loss through efficient credentialing.
• Reduce Paperwork: Avoid the hassle of manual paperwork and form completion.
• Lower Denials: Identify and address provider trends to minimize claim denials.
• Build Payer Relationships: Strengthen connections with various payers.
• Real-Time Status Updates: Receive immediate updates on credentialing and enrollment transactions.

Contact Us: Discover how We5 healthcare’s Provider Credentialing and Enrollment Services can streamline your processes, improve your revenue cycle, and enhance your provider relationships. Join our 80+ clients and revitalize your revenue cycle today!