Value Added Services
Underpayment Analysis
Net Revenue provides a complementary underpayment analysis with no additional data required. The analysis is conducted based on our standard OR and ER review. Our analysis specifically includes reviewing traditional underpayment claims to determine how much is being left on the table.
We also conduct payer contract reviews to help ensure agreements are optimized for hospital performance. Our team manages the review process and works directly with insurance companies so that contract terms are favorable for hospitals.
No Surprises Act
The No Surprises Act (NSA) provides federal protections against surprise billing for certain types of medical care.
Many hospitals do not manage this process effectively. As a result, payers pay out-of-network and the hospital misses out on higher in-network rates.
Net Revenue consults with clients on documentation and billing requirements to bring processes into compliance. Our solution audits out-of-network claims to determine incorrect adjudication. We then negotiate with payers for appropriate payment and, if needed, file dispute resolutions to ensure full reimbursement.
Vendor Management
Any hospital will find our vendor management services useful, particularly rural hospitals. Our vendor management services include 3 key components:
Vendor Report Card: We look at vendor agreements to ensure hospitals are paying a fair rate and that the terms are favorable. This includes analyzing compliance, at-fault instances, and insurance levels. We then review historical performance reports to ensure vendors are performing at an acceptable level.
Consulting: In short, we help the hospital manage vendors. We do this so that hospital staff do not have to worry about managing vendors, and allows them to focus on their responsibilities. The consulting component includes inputting data into a vendor management system, holding monthly performance reviews, and managing processes.
Reporting System: Lastly, we provide the hospital and staff with a custom vendor management tool that monitors vendor performance against goals you set, thus allowing hospitals to hold vendors accountable using mutually agreed-upon performance metrics. This ensures an objective perspective of the vendor’s performance.