Our Objectives

Through use of superior technology, standards, enterprise-wide view and out-of-the-box best practices, deliver to our customers the ability to:

  • Substantially lower complexity and cost associated with billing and insurance-related activities
  •  Improve revenue by maximizing collections

WHAT WE HAVE OBSERVED

The complexity of managing revenue operations has grown and is only accelerating.  As a result, more is being spent on billing and insurance-related activities while collecting for services rendered is often missed.

observed
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In 2012 healthcare delivery organizations spent $230 billion on billing and insurance-related activities. There aren’t any good estimates on revenue lost for failure to collect.

  • $70 Billion Physician Practices
  • $74 Billin Hospitals
  • $94 Billion Other Health Service Providers
  • $230 Billion Total
cost

PROBLEM

Unfortunately, many billing systems are broken. They’re ineffective and fail healthcare delivery organizations from managing cost ($230 billion in 2012) and maximizing revenue.

Why do billing systems fail?

In completing a billing transaction, most billing systems exhibit the same issue …

failure
innovation

In the past twenty years, when it comes to innovation relating to the area of billing and insurance-related activities, legacy vendors have offered graphical user interface – not much more.  It seems like improvements from legacy vendors come only as a response to meeting regulatory mandates such as HIPAA, instead of meeting customer needs in order to deal with growing complexity and cost.

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Standardization

Innovation to incorporate industry standards into billing systems to facilitate uniformity and enable development of standard best practices is almost university missing.  According to Wikipedia “Before the 18th century, devices such as guns were made one at a time by gunsmiths, and each gun was unique. If one single component of a firearm needed a replacement, the entire firearm either had to be sent to an expert gunsmith for custom repairs, or discarded and replaced by another firearm“.  This statement can be made about contemporary billing applications.

 

LONDON - OCTOBER 10: First name/Surname poses for pictures/talks to the media during the Atos Technology Operation Centre launch on October 10 2011 in London, England. The Technology Operations Centre will be staffed by 450 business technologists to monitor and control the IT systems that deliver the results from all the London 2012 Olympic and Paralympic sports competitions (Photo by Tom Shaw/Getty Images for Atos)

360-degree View

360-degree customer view is an innovation that is well developed and is expected when it comes to customer relationship management (CRM) applications.  Yet, 360-degree transaction view as it relates to rendering patient care is almost unheard of.

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Digitalization

Digitalization is to healthcare delivery organizations’ revenue operations what assembly line has been to manufacturing since Henry Ford introduced it to car production.  Yet, billing systems lacking the basics of standardization and 360-degree view of each transaction life cycle, can’t be incorporated into a digitalization effort, to drive down complexity, cost and improve revenue.  It is a true digital divide.

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Best Practices

By definition only one of set of best business practices can exist.  If everyone of a vendors’ customers has a different implementation because different administrator and business analyst groups are responsible to implementation and maintenance “their” version of best practices, then especially no one has a set of best practices.  Innovation is how to deliver “best practices” is lacking.

SOLUTION

“Think globally, act locally” – an idea we’ve borrowed from the environment movement.  In developing solutions to address complexity and cost associated with billing and insurance-related activities, we have thought “globally” and built CHC Enterprise, incorporating industry standards and enterprise wide functionality.

“Locally”, we’ve build cloud service solutions like Enterprise Revenue Documents (ERD) to empower our customers with digitalizing operations and take advantage of out-of-the-box best practices – in the case of ERD, which eliminates paper and introduces revenue cycle management specific optimized processes.

 

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CHC Enterprise
Gateway to Digitalizing Revenue Cycle Management