Parathon has recovered billions of dollars on behalf of hospitals, health systems, and physician groups.
Our collection consultants work exclusively in the Parathon Parallel Database (PDB) utilizing Parathon’s patented RCM technology to process claim receivables that would otherwise prove difficult, if not impossible, for hospitals or other vendors to collect.
Parathon can recover unrecognized revenue from complex claims and generate immediate cash flow for your hospital.
Revenue Recovery Services Include:
- Underpayments – Managed Care
- Zero Balance
- Zero Payment
- Denial Management – Clinical & Technical
- A/R Follow-up
- ED Claims Recovery Services
UNDERPAYMENTS
-
- Identify and resolve issues preventing optimal and compliant payments per established Provider/Payer contracts
- Identify and appeal underpaid accounts directly with Payers
- Adjudicate 100% of all Provider’s contracts
- Fast and accurate Claim Validation against the contracted terms
- Easily pinpoint coding, registration, charge and capture trends
- Extensive reporting to the penny and ability to create custom reporting
- Root-cause Analysis and Trends Reporting by department
ZERO BALANCE
-
- Adjudicate 100% of all Provider’s contracts
- Fast and accurate Claim Validation against the contracted terms
- Easily pinpoint coding, registration, charge and capture trends
- Extensive reporting to the penny and ability to create custom reporting
- Root-cause Analysis and Trends Reporting by department
ZERO PAYMENT
-
- Includes accounts in which the Payer has not responded to a claim with either a payment or a denial
- Root-cause Analysis and Trends Reporting by department
DENIAL MANAGEMENT – CLINICAL & TECHNICAL
-
- Authorization
- Inpatient Level of Care/Length of Stay
- Billing & Coding Discrepancies
- Timely Filing
- DRG and SOI Downgrades
- Experimental/Investigational Services
- Medical Necessity
- Coordination of Benefits
- NCCI Bundling Edits
- Coverage and Benefits
A/R FOLLOW-UP
-
- Worker’s Compensation
- Government and Commercial
- Pre-conversion Rundown
- Upgrade Option Available: Parathon Staff performs services when the hospital is short-staffed and in need for follow-up representatives
ED CLAIMS RECOVERY
-
- Unique Medicaid rules for Georgia, Indiana, Maryland, Texas
- Detailed follow-up and specialized appeal process on every underpaid Medicaid Managed Care Claim
Allow us to show you how our services can transform your collections by scheduling a complimentary consultation with our expert team.
