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< Previousgrowing expenses, it’s a constant concern for many. According to the New York Times, there was an estimated $140 billion in unpaid medical bills held by collection agencies last year – and that doesn’t count the amount of unpaid bills in pre-collection status. This leads some organizations to aggressively pressure patients for payment while it leads others to take write-offs to avoid potentially upsetting patients and losing future business from them or their referring physicians. But there’s a better way to both increase revenue and provide a positive patient experience at the same time, according to John (JD) Donnelly, Founder and CEO of FrontRunnerHC (www.FrontRunnerHC.com), a leading SaaS solutions provider for revenue cycle management (RCM). “The healthcare ecosystem is often out of balance,” Donnelly says. “I think of it like a pendulum. If healthcare organizations try to increase reimbursements by applying pressure in the wrong way, it can drive down patient satisfaction which can negatively impact physician referrals and repeat business. We encourage our clients to take a more balanced approach, leveraging data automation to improve their bottom line as well as the experience for their patients and referring physicians.” Working with several hundred clients across the country, Donnelly understands the challenges that threaten reimbursements and the patient experience, and he understands the key cause of many of those challenges: bad data. Missing or incomplete patient data leads to rejected claims, lost revenue, physician and patient dissatisfaction, costly rework, and staffing constraints. Getting the right patient demographic and insurance information is harder than you think for healthcare organizations, especially with people constantly moving and changing insurance plans. According to an article by Axios, it’s reasonable “to estimate at least 2 million workers and their families lose or transfer to new commercial health plans every month.” Solutions to zero in on the problem Donnelly and his team have developed a platform of data automation solutions that zeroes in on the problem, and their 2-week product development sprints drive constant innovation to help stay ahead of the dynamic market. By instantly serving up accurate patient insurance, demographic, and financial information exactly when and where their clients need it, FrontRunnerHC enables them to address the challenges fast – or avoid them altogether. “We have built the technology to fix the patient information before the patient even gets the bill so the patient is happier and more reimbursements are collected faster,” says Donnelly. That’s good news to organizations whose bills often go unpaid. Moreover, it’s good news in light of the growing consumerism, with patient expectations rising daily and yet often going unmet. Examples of patient dissatisfaction can be easily found in surveys indicating frustration, confusion, and surprise related to medical bills. With complete and up-to-date patient information, healthcare facilities can automate and expedite their workflow and allow their staff to focus on more value-added efforts. Without it, the problems persist and multiply throughout the process, driving up operational inefficiencies and expenses and putting patient satisfaction and revenue at risk. FrontRunnerHC helps organizations combat the issues that arise throughout the patient’s financial journey – from patient registration through bill payment – by putting clean patient insurance, demographic, and financial information at their fingertips. While they encourage clients to leverage their solutions upfront to capture the patient’s data and fix any errors right away, clients can choose to use them anywhere they want in their process including on the backend. The information is accessible instantaneously on demand (realtime) or in batch – whatever the client prefers. Because patient information frequently changes from the time of scheduling to their appointment as they may move, switch jobs, or change insurance plans, FrontRunnerHC suggests accessing the data “as early as possible and as often as needed” to help catch any changes and avoid forfeiting reimbursement. One of FrontRunnerHC’s flagship solutions within its portfolio is PatientRemedi®. The software finds, cross- checks, and even fixes patients’ demographic and medical insurance information (including coordination of benefits (COB) coverage for MCOs & Medicare Advantage Plans), and can automatically post the correct data back into the client’s existing system if they would like. This data helps healthcare organizations ensure claims sent to payers or patients for reimbursement are right the first time for the highest clean claims rate. “Our network of payer connections which is extensive and constantly growing enables us to instantly access federally regulated data to find up- to-date patient info, enabling touchless clean claim submission and expediting reimbursement,” explains Donnelly. From the patient payment perspective, a good strategy, per Donnelly, is having the ability, on demand, for authorized users to understand a patient’s unique financial situation and likelihood to pay. PatientRemedi provides relevant financial information about the patient that helps healthcare organizations make decisions that are best for both the patient and them. Using the software to gauge patients’ propensity to pay and determine financial disposition strategies, lab and healthcare administrators may choose to offer payment plans, prompt pay discounts, or even hardship discounts to patients who fall under the Federal Poverty Line (FPL) and who may have otherwise postponed care due to affordability issues. While the tools can benefit patients, they can also help improve an organization’s collection strategy. Marrying patient financial information obtained via PatientRemedi with historical patient collections data provided by the client, FrontRunnerHC can see where clients have been most and least successful in collecting from patients and recommend and execute operational changes to maximize future collections. One large genetic lab client recently saw patient payment collections increase by 8% within 30 days of the first bill by leveraging the software. Using insights from the tool, organizations might also choose to send a collection agency only the past-due accounts for patients who have a low likelihood to pay rather than sending them all past due accounts and focus in-house efforts on the others. Donnelly emphasizes that the answer to increasing healthcare collections isn’t necessarily sending more bills and making more calls. That approach, he says, can backfire, creating patient dissatisfaction – and add more work for staff who is most likely already stretched thin. “To increase reimbursements, patients must be at the center of an organization’s revenue cycle strategy,” says Donnelly. He encourages they create a patient-centric experience from beginning to end, provide the patient a good estimate of their expected costs including knowledge of what’s covered, and get them an accurate bill that aligns with the estimate and their financial situation once the service is provided – or better yet, at the time of service. “Super Clean Order leads to a Super Clean Claim” Capturing accurate patient data up front at order entry when a healthcare service or lab test is scheduled is ideal in helping to create a patient-centric experience. FrontRunnerHC is working with more and more organizations daily who see the value of catching and fixing problems early by cleaning the data at the front end to drive a better patient experience. And with insurance eligibility and registration issues the #1 reason for claims denials according to an article featured in MGMA, it can also reduce denials, inefficiencies, and expensive rework. “With so much pressure on organizations, they don’t have time or money to waste manually fixing patient information errors which I’d estimate is a factor in about one-third of claims prior to submission. We are providing tools so labs have clean patient data before it goes into their system. A super clean order leads to a super clean claim,” exclaims Donnelly. LabXchange®, the company’s vendor-agnostic electronic order entry system, helps labs expedite the time needed to collect and process tests. And it also enables them to communicate directly with patients when results are ready and allows results to be viewed instantly. The Power of Partnership Leveraging the vast expertise of its team – many of whom have walked in the clients’ shoes, FrontRunnerHC takes a consultative approach as it partners with clients, helping them optimize each solution to navigate the industry challenges and achieve their specific goals. Moreover, the company continually innovates their technology, collaborating with clients, partners, and other industry experts to ensure clients have sustainable solutions with a competitive edge. “The industry looks to us to drive change and always be innovating on ‘the next big thing’. We’re constantly focused on enhancements and new solutions that create a better experience for our clients and their patients,” Donnelly comments. A pioneer in delivering cutting-edge revenue cycle management and medical billing software, the company’s 2-part mission to help clients improve their bottom line while enhancing their patients’ experience is being accomplished. Donnelly shares many instances of John (JD) Donnelly, Founder & CEOassisting their clients. In one example, he talks about partnering with a large lab that handles about 35,000 patients a day. “Collections went up significantly because of the solution and patient satisfaction went through the roof.” He adds, “We focus on our clients’ goals and celebrate their success. In fact, our Million Dollar Club recognizes clients who have uncovered over a million dollars in revenue in a calendar year with our software. In 2021, almost a third of our clients uncovered anywhere from $1 million to over $90 million.” Redefining the Future Today, with numerous awards and success stories already on the list (including Inc. magazine’s list of “America’s fastest-growing private companies” for four years in a row and Inc.’s recent list of “America’s Best Workplaces”), FrontRunnerHC has no intention of becoming complacent. Donnelly launched the company in 2010. Early in his career, he worked with insurance companies and industry stakeholders to establish data standards and automation technology to support the electronic transmission of patient data for insurance billing. His commitment to collaboration, agility, and innovation – what he refers to as the core pillars of the FrontRunnerHC culture – has never wavered. It is Donnelly’s unrelenting passion with the blend of his expertise that fuels the team’s success and their ability to continually empower healthcare facilities and labs. While the healthcare space faces increasing challenges, FrontRunnerHC is driving positive change with connected and automated solutions. “We’re always working to positively transform healthcare in ways that most people haven’t even thought about,” says Donnelly. “Too often, insurance companies, healthcare facilities, labs, physicians, and patients are in silos. When I think of the future of healthcare, I see a fundamental change in how billing and testing occurs. We are working with all of them to break down the silos for a more cohesive and integrated ecosystem where everyone wins,” concludes Donnelly. We encourage our clients to take a more balanced approach, leveraging data automation to improve their bottom line as well as the experience for their patients and referring physiciansEvery organization struggles to manage its Specialty Drug spend. ELMCRx Solutions understands the complexity of specialty drug management. By combining powerful clinical management with real-time oversight to control costs and prevent unnecessary payments, our unbiased program helps deliver the best outcome for the plan sponsor and the member. We partner with employers, health care coalitions, health plans, insurance captives, TPAs and Taft-Hartley Trusts. Cost Containment Solutions and superior clinical outcomes are achievable. ELMCRx Solutions is the partner to help you achieve them. Better manage your specialty drug spend, through powerful clinical management combined with real-time oversight. CONTACT US TODAY John Adler jadler@elmcgroup.com | 262 707.1076 Mary Ann Carlisle mcarlisle@elmcgroup.com | 484 433.1412 elmcgroup.com An ELMC Risk Solutions CompanyE very industry is embracing the developments in these technologies to optimize business processes to meet current difficulties and gain competitive advantage as analytics, AI, and automation become more commonplace. This is where RCM is helping healthcare facilities by effectively dealing with the treatment payment lifecycle, which includes patient registration, claims generation, claims submission to the payer, and revenue collection for healthcare services provided to the patient. AI is progressively making its way into the RCM. To switch staff to denial management, service providers have enhanced payer portal use, automated payment posting, and automated status. Growing healthcare consumerism has a wide range of effects on how care is provided. This megatrend is entwined with issues like price transparency, no-surprise billing, digital health, branded care delivery systems, and more. The medical industry is in a transformation phase, and more solution providers are stepping into the space to offer improved and more convenient healthcare services. Our team of researchers, CEOs, CIOs, and healthcare veterans have selected a list of the Top 10 RCM Solution Providers 2022 who are a step ahead of the industry. The companies listed here are on a mission to redefine the way RCM work today. Innovators Medhealth Outlook 2022 RCM accuregsoftware.com Website Orlando, FL Headquarters Paul Shorrosh Management Founder & CEO Designation AccuReg has one simple, clear focus: Optimizing the front-end of the revenue cycle. This is the best place to help the RCM industry perform better at a lower cost. In fact, as hospitals are being squeezed to become more efficient, effective and less costly, the front-end is the only place left for the RCM industry to go. AccuReg Description availity.com Website Jacksonville,FL Headquarters Russ Thomas Management CEO Designation Availity is the place where healthcare finds the answers needed to shift focus back to patient care. We work to solve communication challenges in healthcare by creating a richer, more transparent exchange of information among health plans, providers, and technology partners. As the nation’s largest health information network, Availity facilitates billions of clinical, administrative, and financial transactions annually. Avality Descriptionfrontrunnerhc.com Website Plymouth, MA, USA Headquarters John (JD) Donnelly Management CEO Designation FrontRunnerHC’s data automation platform helps healthcare organizations maximize reimbursement while also enhancing their patients’ experience with instantaneous access to patient demographic, insurance, and financial information as early as possible and often as needed. FrontRunnerHC finds, verifies, and fixes patient information in real-time or batch, and at any point during the care journey from registration through payment, leveraging its access to the most payers in the industry. Defining the patient experience as the clinical journey + the financial journey, FrontRunnerHC helps address the challenges that jeopardize both the organization’s ability to get paid and their patients’ experience. FrontRunnerHC Description imagineteam.com Website NY, NY Headquarters Sam Khashman Management Founder & CEO Designation ImagineSoftware is a leading provider of practice management applications and medical billing and automation software. ImagineSoftware is cutting-edge technology for medical billing offices, practices, and hospitals that improves efficiency and while increasing cash by applying high-quality standards to data integrity. committed to innovative development and intelligent automation to help clients achieve peak performance and measurable results. ImagineSoftware Description pararevenue.com Website Downingtown, PA,US Headquarters Jerry Connelly Management President & CEO Designation Parentiv, Inc. is a technology platform provider for parents, therapists, and teachers of special needs children enabling them to collaborate for better therapy outcomes. Pararev team is comprised of parents of special needs kids, autism professionals with decades of clinical experience, and technology professionals who are driven by the desire to create bigger impacts in society by applying cutting- edge technology in the most underserved markets. Pararev Description chartlogic.com Website Salt lake, UT Headquarters Chris Langehaug Management CEO & President Designation ChartLogic offers a full ambulatory EHR suite, including electronic medical record, practice management, medical billing services, e-prescribing, patient portal and more. Although ChartLogic includes hundreds of distinct features, it’s the overall charting experience that sets it apart: truly easy, incredibly flexible and super-fast. Chartlogic DescriptionPractolytics is a 20+-year-old healthcare technology and management company. Practolytics provide end-to-end solutions to eliminate revenue cycle management inefficiencies, maximize revenue and consistently deliver optimum results. Practolytics is one of the leading multi-specialty billing companies providing One-Stop Revenue Cycle Management for Healthcare. Practolytics Description purviewservices.com practolytics.com Website Website Edinburgh, Scotland Columbia,US Headquarters Headquarters Mihir Mehta Manik Chawla Management Management Co-Founder & CEO CEO Designation Designation Purview is a mix of strategists, creative directors, designers, technologists, developers, and relationship builders. They are committed to creating a vibrant and relevant experience on every level through product and technology capability. Purview is a high yield and technology-empowered Revenue Cycle Management organization that provides medical billing and medical coding services to prime healthcare providers across the United States. Purview Healthcare Description r1rcm.com xifin.com Website Website Murray, UT San Diego, CA Headquarters Headquarters Joseph Flanagan Lâle White Management Management CEO Founder & CEO Designation Designation R1 is a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers.R1’s proven and scalable operating models seamlessly complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience. XIFIN is a health information technology company that leverages diagnostic information to improve the quality and economics of healthcare.The XIFIN technology platform facilitates connectivity and workflow automation for accessing and sharing clinical and financial diagnostic data, linking healthcare stakeholders in the delivery and reimbursement of care. R1 RCM XIFIN Description DescriptionPAGE NO 18 REDEFINING CHANGE, CULTURE, AND CAREERS IN HEALTH CARE TECHNOLOGY IMAGINE SOFTWARE : T he adoption of new technology in the healthcare industry has historically been hesitant at best and incredibly delayed at worst, with both patients and doctors often favoring tradition over innovation. ImagineSoftware, a top supplier of revenue cycle management and medical billing automation software with its headquarters in Charlotte, is working to change this perception. Challenges and change are nothing new to ImagineSoftware. Despite decades of continuous health care rules, most recently the No Surprises Act, and increasing calls for market pricing transparency, the firm, launched in 2000, has experienced fast development. “Every season, every challenge, is simply an opportunity for our team to excel, to recognize the increasing demand for improving accuracy, efficiency, and workflows,” says Sam Khashman, president and CEO of ImagineSoftware, in the statement. “We continue to grow and adapt, always remaining motivated and responsive, customer-focused, and open to new ideas.” “Yes, we are confronting a time of unprecedented change in health care during a time of larger national and global change. Technology in health care remains, as ever, a truly dynamic field, but no matter what is on the horizon, Imagine will continue to bring inspired people together to ensure we remain united and at the cutting edge. “ The first items that ImagineSoftware commercialized were systems for HCFA processing and insurance denial mitigation. The company had to create its physician enterprise billing system to take advantage of its core competencies and technologies in document imaging, workflow effectiveness, and process automation. These systems were coupled with existing practice management and physician back- office applications that were based on older technology. Exchange EDI was recently acquired by ImagineSoftware. According to the announcement, the business is expanding “significantly,” and the purchase will further the company’s goal of providing clients with software solutions. In the statement, Khashman adds, “With our combined technology and the insights it provides, we are uniquely positioned to improve communication between providers and their patients. “Housing an abundant amount of healthcare data, patients depend on you to safeguard, it is crucial to use a data center you can trust. Rest easy using our fully HIPAA-compliant center, focused solely on the healthcare industry. Plus, leverage our Payment Card Industry (PCI), and Service Organization Control (SOC, Type I and Type II) certifications, as we adhere to industry standards and beyond.” Innovators Medhealth Outlook 2022 RCM19 PAGE NO huddles, biweekly department meetings, and semi-annual company- wide vision day events. By providing a wide range of perks and advantages, such as flexible work arrangements, wellness incentives, paid volunteer hours, maternity leave, tuition reimbursement, and more, employers show their appreciation for their staff members and encourage them to reach their full potential. ImagineSoftware demonstrates that culture and career go hand in hand for establishing and retaining employee happiness and lowering turnover with an above-average duration of six years, compared to the national average of roughly four years. “Our clarity of purpose and sense of mission remains at the heart of our company culture,” says Khashman. “Although the data is important, it is just the starting point. It’s really about cultivating a company culture centered around servant leadership by celebrating differences, encouraging an inclusive atmosphere, and prioritizing efforts that strongly show our commitment to building a company with a variety of backgrounds, skills, and views. Innovation, motivation, accountability, genuine integrity, a no-excuses attitude, and excellence are the fundamental values that we follow every day to drive our progress. Over the past 22 years, we’ve worked to bring our culture and values to life — not just through what we do, but how and why we do it — for the betterment of our clients and employees, and to offer dynamic healthcare software solutions.” Over the past 22 years, we’ve worked to bring our culture and values to life — not just through what we do, but how and why we do it — for the betterment of our clients, and employees, and to offer dynamic healthcare software solutions With a team that currently supports more than 43 specialties and 200+ million procedures, ImagineSoftware drives powerful technology solutions for medical billing offices, practices, and hospitals. These solutions improve financial efficiency, foster provider reputation, and ultimately improve the patient experience. Communication and openness are important pillars of the company, which has close to 200 workers working remotely around the nation and in three corporate offices. Intending to dismantle silos and foster accessibility across departments, the Imagine team efficiently interacts using video conferencing technologies, weekly company-wide Sam Khashman, President and CEO Next >