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    Billing, Claims and Contract Management

    Billing, Claims & Contract Management

    As reimbursement changes become a reality, your organization needs a strong financial foundation in order to succeed.

    Our integrated billing, claims and contract management solutions enable your organization to verify expected reimbursements and manage any variances and denials right within your workflow.

    A single platform designed to enable cleaner claims, improve communication and speed up reimbursement

    Power of integration

    We’ve built our clinical and financial solutions on a single platform, which reduces the need for foreign interfaces and enables a single point of accountability.

    • Integrate communication between billing and clinical teams to help improve process efficiencies (users can see patient financial data and, with appropriate security, link directly to the chart for any necessary reviews)
    • Leverage functionality like work queues to help manage collections
    • Manage denials, variances and appeals in a single workflow (enhanced functions available when integrated with our contract management solution)
    • Track financial performance across your entire system
    • Quickly post payments to view a patient’s account status
    • Store and retrieve documents electronically using imaging technology

    Near Real-time charge capture based on clinical activity

    • Create charges based on clinical documentation
    • Route charges automatically
    • Transform charges to handle state and payer requirements
    • Determine charge information (i.e. prices, CPTs, revenue codes, etc.) by tiering logic based on specific criteria (insurance plans, encounter types and location)

    Advancing the claims process

    • Remove the need for foreign interfaces to Cerner’s clinical systems
    • Support payer billing requirements with flexible claims rules
    • Push assignments to your billing staff using automated work queues allowing them to prioritize their work
    • Create custom workflows based on business office needs
    • Send statements and letters automatically to patients and payers using Cerner’s correspondence service

    Manage your payer contracts

    • Manage the life cycle of a reimbursement contract
    • Leverage a variety of reimbursement calculations and claim qualifying types
    • Re-price historical claims in near real-time and post them back to a patient account
    • Access more than 30 Federal, State and Commercial Prospective Payment Systems

    Document

    Read the stories of our clients' successes using Revenue Cycle Management solutions.

    Cerner Events

    Request a RCM Speaker's Bureau speaker for your next event.

    Partnership

    Watch our Revenue Cycle Management client achievement video playlist.

    More About Billing, Claims & Contract Management

    How a Clinically Driven Revenue Cycle Can Build a Healthier Bottom Line

    The health IT landscape is constantly evolving. Shifting consumer behavior patterns, coupled with the industrywide transition from fee-for-service to fee-for-value models, means that hospitals and health care providers must structurally adapt in order to remain successful.

    How a Clinically Driven Revenue Cycle Can Build a Healthier Bottom Line

    Nicklaus Children

    Nicklaus Children's Hospital

    This past July, South Florida’s only licensed specialty children’s hospital, Nicklaus Children’s Hospital, formerly known as Miami Children’s Hospital got closer to completing their clinically driven Revenue Cycle journey on time with the successful launch of Cerner Patient Accounting. The organization was also able to implement interfaces between three pre-collection agencies and one collection agency. Just three months after go-live, Nicklaus Children’s Hospital surpassed cash collection goals by 15 percent and recorded October 2014 as one of the highest cash collection months in its history.

    80% reduction in eligibility denials over nine months by using Cerner Soarian Financials – Cape Cod Healthcare

    Increased case collection by $6M+ within the first six months of implementing Cerner Patient Accounting in July 2014 – Nicklaus Children’s Hospital

    Adventist Health Revenue Cycle

    Clinically-driven revenue cycle nets cleaner claims for Adventist Health System

    In two years, one of the largest non-profit health systems in the U.S. saw its clean claims rate climb ten percent. It credits that, in no small part, to its comprehensive and clinically-driven revenue cycle solution.

    Clinically-driven revenue cycle nets cleaner claims for Adventist Health System

    Related Offerings

    Case Management

    Connect clinical and financial information and automate utilization management, clinical documentation improvement and discharge care management within Cerner’s EHR.

    Health Information Management & Coding

    Electronically monitor, support and manage health information of all types for a comprehensive, secure medical record.

    Lights On Network

    Integrate a full data-driven approach to managing your Revenue Cycle program to drive value through your financial operations.

    Patient Access

    Get complete and accurate information at the point of service to help manage your cash flow.

    Practice Management

    Enable a comprehensive workflow including registration, scheduling, patient tracking, patient accounting and reporting through a single platform in the ambulatory setting.

    Revenue Cycle Management Services

    Integrate people, process and technology, to help improve workflow efficiencies, meet organization metrics and control cost to collect.

    FAQs

    Can I access the patient chart directly if I need to review specific clinical information related to a claim?

    Our billing, claims and contract management solutions can integrate communication between billing and clinical teams to improve process efficiencies. Users can see patient financial data and, with appropriate security, link directly to the chart for any necessary reviews.

    Our Revenue Cycle Operational Reporting tracks performance across your entire system.

    With Cerner Patient Accounting, you have the ability to push assignments to your billing staff using automated work queues allowing them to prioritize their work. Additionally, you can create custom workflows based on business office needs.

    With Cerner Contract Management, you have the ability to re-price historical claims in near real-time and post them back to a patient account.