Parathon has recovered billions of dollars on behalf of hospitals, health systems, and physician groups through our first-in-class Revenue Recovery Services. Unlike other RCM vendors, Parathon does not rely on EMR or other Legacy systems to perform revenue follow-up services.
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:
- Zero Balance
- Underpayments – Managed Care
- Denial Management – Clinical & Technical
- Zero Payment
- A/R Follow-up (aka/ A/R Rundown)
- Specialized ED Claims Recovery Services (SEDCRS)
ZERO BALANCE
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- Parathon’s Zero Balance PDB service is designed to adjudicate 100% of all Customer’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
- Parathon provides root-cause analysis and trends reporting by department to increase Customer’s cash to prevent future Zero Balance accounts
UNDERPAYMENTS
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- Underpay placements the following requirements would be included: (potentially reduce rates for underpay/zero pay vs zero balance).
DENIAL MANAGEMENT – CLINICAL & TECHNICAL
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- Authorization
- Inpatient Level of Care
- Billing Discrepancies
- Timely Filing
- Experimental Services
- Medical Necessity
- Coordination of Benefits
ZERO PAYMENT
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- Includes accounts in which the payer has not responded to a claim with either a payment or a denial
- Parathon will follow-up to see if the claim was received, rejected, paid or denied
- Parathon provides root-cause analysis and trends reporting by department to increase Customer’s cash reimbursement and lower Customer’s AR days
- Requires Claims, Remits, and Placement files
A/R FOLLOW-UP (aka/ A/R Rundown)
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- Worker’s Compensation
- Government and Commercial
- This is primarily done with the FTE model with JDA/Parathon staff working as the PFS staff
- JDA/Parathon makes adjustments to follow the account and bring it to a Zero Balance or identify the “Patient Bucket” (what’s left is what the patient owes)
SPECIALIZED ED CLAIMS RECOVERY SERVICES (SEDCRS)
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- Unique Medicaid rules for specific states
- Specialized appeal process for these Medicaid/Management Care Plan underpayments
- Detailed follow-up on the specialized Medicaid/Management Care Plan underpayments
- Requires Claims, Remits, and Placement files
Allow us to show you how our services can transform your collections by scheduling a complimentary consultation with our expert team.
