The practice of medicine is becoming more technically advanced and more complex. Hospitals and medical practices are facing managed care competition, new legislation and federal mandates. Physicians are burdened by tasks and procedures that increase their workloads. Insurers are demanding steeper discounts and reducing fees.
At Hawthorn we address complexity with certainty. Our approach to revenue cycle management is based on a set of promises we call The Hawthorn Advantage. We will maximize your reimbursements, improve your cash flow and increase your profitability.
Your claims are submitted accurately. We identify inaccurate codes during the initial transaction entry step—rather than during claims processing. Your claims are reimbursed quicker because incorrect codes are edited and eliminated.
Your rejected claims are worked daily. We manage rejection reports, correct the rejected claims and re-transmit immediately. We hold payers accountable for their contracted pay amounts and collect what you are due to be paid.
Your claims are retained longer and worked harder. We place fewer bad debts with collection agencies and deliver more profit to your bottom line. No other company can match our stamina when pursuing unpaid balances.
Hawthorn’s work groups are organized by medical specialty. Separate teams are responsible for claims from emergency, pathology and radiology practices, and each group includes team leads that report to group managers.
Our specialty teams minimize the turnaround time of charges to insurance companies. When teams receive electronic reports they immediately match the reports with patient demographics and verify the CPT-4 and ICD-9 codes. Claims are sent to insurance carriers within 48 hours.
Specialty teams work denied claims as soon as payers’ explanations of benefits (EOB) reports are received from our payment posters. Our Claims Tracking/Denial Management software identifies trends in denials, so Hawthorn can determine when denials are linked to coding issues, demographic issues or claims filing issues. When denial trends are observed with a specific payer those denials are elevated to the dedicated A/R team for settlement.
Since each team is responsible for a single medical specialty, team members understand the patient issues and medical necessities that have created the claims—as well as the preferences of the practices and individual physicians that are submitting those claims. They process your claims with a high level of familiarity and confidence.CLOSE
Hawthorn takes a proactive approach to accounts receivable management, with tactical teams that confront A/R directly. These teams integrate financial, operational, strategic and compliance considerations to collect your receivables.
Revenue/Payment Posters review explanations of benefits (EOBs) to assure your payments are remitted on time, accurately and in compliance with contractual terms. They review and appeal your denials on the spot.
Accounts Receivable Representatives work directly with your patients to resolve open account balances. They collect corrected information and get services paid. They also work with the Revenue/Payment Posters and Senior Accounts Receivable Representatives to identify trends and plan corrective actions.
Senior Accounts Receivable Representatives are responsible for managing detailed aging reports, focusing on your third-party payers. Senior Accounts Receivable representatives have established high-level contacts among all payers, including Blue Cross Blue Shield, Medicare and Medicaid. Their experience gives them direct access to the individuals that can help them resolve your issues and expedite your claims.
Team members understand the formal review and appeal processes for all third-party carriers, and they pursue your claims effectively when reimbursement levels are insufficient. Hawthorn’s experienced team members will accelerate your revenue recovery, reduce bad debt and minimize redundant processes.CLOSE
Hawthorn is organized to serve new clients. We have developed a proven system for minimizing disruptions while maximizing revenue. We deliver step-by-step task descriptions, checklists, progress reviews, and coding feedback consultations.
Our client service representatives (CSRs) are responsible for addressing all your business needs, including special contracts, special billing arrangements and collection agency processes. CSRs analyze your financial results to identify reimbursement trends and patterns of denial. Guidelines for customer contacts are addressed during regularly scheduled training sessions.
Formal guidelines for compliance are spelled out in Hawthorn’s corporate compliance program and are also covered during training. You will have an opportunity to provide specific directions for how your accounts should be handled, such as guidelines for filing claims, posting payments, managing collections and writing off bad debts.CLOSE