Revenue Cycle

Revenue Cycle Management

Just What the Doctor Ordered!

Let Legacy provide the PRESCRIPTION for your financial health.

How can we help? We simplify the complex.

No, one size doesn’t fit all – healthcare organizations are under pressure to improve the quality of care, while facing declining reimbursement and increased risk. Maximizing revenue cycle efficiency and improving the areas of medical billing, coding and accounts receivable management are critical to achieving these goals – of course, most of the time, without additional capital expenditure.

Healthcare organizations need both proven best practices and customized solutions. Legacy offers you proven best practices, customized to meet the unique needs of your organization.

We help you:

• Increase Net Revenue

• Improve Revenue Cycle Management Efficiency

• Identify Cash Flow Opportunities

• Reduce Administrative Burdens

With Legacy Revenue Cycle Management, hospitals and healthcare practices can increase cash flow to help achieve sustainable financial performance.

We identify reimbursement opportunities that can deliver an immediate return.

The 5 keys to RCM

The key is to uncover specific areas responsible for the financial under-performance. We have the teamwork expertise, depth of experience, and benchmarks needed to accurately assess your revenue cycle, address the challenges, and improve profitability. As an extension of your team, we have the resources needed to strengthen the financial health of your organization – and all without adding more time to your day or costs to your bottom line.

Consider partnering with us to manage your entire revenue cycle so you can focus on delivering quality care.

Increasingly, CFOs are partnering with experts to administer core revenue cycle management processes to become more operationally efficient and improve financial performance. Imagine if your hospital or healthcare practice had the resources it needed to devote more time and energy to patient care.

Our end-to-end revenue cycle management and medical billing services can provide as much or as little help as you need.

If your healthcare organization is struggling to improve its revenue cycle operations, our domain expertise in both physician and hospital billing and claims management, combined with end-to-end revenue cycle management services, can help your organization reduce operating costs and accelerate cash flow.

Our partnership approach allows us to address both the issues and the opportunities facing your organization.

We work with your team to analyze your operational needs, compare performance to industry-leading benchmarks and develop the go-forward plan to optimize revenue cycle operations and implement revenue cycle best practices across your health system and across multiple information systems. We understand that no single solution or one-time fix can address the challenges hospitals and physicians face in this dynamic healthcare environment.

Talk with us today!

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Coding Services

Backlogged claims because of coding delays?

With open positions or untrained coders, backlogs occur and revenue is delayed. Healthcare organizations across the nation struggle with the recruiting and retention of qualified, experienced coders. With the change to ICD-10 coding in October of 2015, medical coding has become a more dynamic process than ever before.

Our team of Coders can handle your specific specialty. From Anesthesia, Physical Therapy, Psychology, Rheumatology, Nephrology, Cardiology, Internal Medicine, General Surgery, Cardiovascular, Neurology, Hospital Inpatient and Outpatient, Emergency Room, Observation, to Critical Access Hospitals, we have someone to ensure proper coding, not only for auditing purposes, but also to increase clean claims that meet payor specific guidelines for proper reimbursement.

We help you overcome the issues associated with coder staffing, retention, and training.
We provide Superior Outcomes for Your Practice!

• Reduced claims denials
• Lower receivables and improved cash flow
• Experienced, professional claims billing in many points of service
• Services within your budget and deadlines
• The highest coding quality standards – Guaranteed!

At Legacy, we are committed to quality and we remove the pain from the coding process. We can help you in a staffing shortage or take over your coding entirely.
Whether you need help for a short-term or long-term coding project, our staff is here to help.

Let us help with your coding needs!

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Medical Billing Services

We simplify the complex!

Are you tired of the administrative burden of turnover, training costs, coding changes, and much more? With our Medical Billing Services, we take the hassle out of handling your claims.

We focus on billing, so you can focus on patient care. Our team understands that you did not go into healthcare to master the billing or administrative processes. You spent years in school so that you could enjoy a career of helping people. So, while you focus on your patients, we ensure that your claims go out timely, accurately and take care of all the steps to ensure that you get paid faster.

Our expert Billers are ready to handle the entire billing process from keying charges, submitting claims, working edits, rejections and denials, to in-depth account reviews to increase revenue.

Our teams are prioritized for each client as to how to best meet their needs. Some AR teams may work specific clinics, other may work specific payors, depending on what we have assessed to be the best organization for your specific business model. These AR teams are focused on touching every account in your AR in 30-45 business days, depending on the volume of AR we work for your organization.

Worklists are focused to collect the greatest amount of cash as quickly as possible. The AR is worked every day with targeted AR buckets focused on each week to get outstanding claims paid as swiftly as possible.

Medical Billing Workflow (1)

Now, you may say, other than that, why should I outsource my billing or any function in my back office?

These are just a few of the benefits:

1. Healthcare is a changing industry.

We all know that the healthcare industry is changing a very rapid pace. Keeping up with the changes in state and federal rules and regulations is difficult and requires constant staff education. These changes in healthcare payment guidelines, diagnosis and CPT coding affect all aspects of billing. We do our very best to stay abreast of these changes, so we can handle the complexities of billing and coding, so you don’t have to.

2. We provide a team of dedicated, highly trained billing experts.

The team has one purpose — that is to bill with accuracy, compliance and improve the profitability of your practice. They work all edits and rejections, as well as review and post all payments to ensure that payors are paying the correct amount to prevent incorrect adjustments. Every claim is tracked until it is processed and paid. They also work closely with your office staff to ensure an efficient workflow.

3. You get paid faster.

We know that cash flow is key and that your primary reason for outsourcing is so claims are submitted faster, and with fewer errors, and so that you receive payment in the shortest amount of time possible. We ensure that electronic transmission of claims is occurring with all payors that offer it. We also assist with setup for your group to receive as many EFTs and ERAs as possible, even further reducing turnaround times.

In summary, every practice is unique, and insurance billing can be complicated. To provide the best value possible, we tailor our service offerings and pricing to each of our clients to ensure they are only paying for the services they need. We can provide a customized quote, usually within 48 hours, and we work around your needs and availability.

Contact us to get started now!

Considering outsourcing, but just not sure? Our free assessment can help you decide. We evaluate key elements of your revenue cycle and determine if you’re as financially healthy as possible. Using our medical billing services, we can provide you with an sizable return on investment (ROI), due to our diligent and focused billing, rejections, denials and accounts receivable follow-up processes. What would your specific ROI be if you used Legacy as your medical billing company? Give us a call, and we’ll be happy to provide estimates for you.

Get Your Free RCM Assessment Today!

Interim Practice Management

Legacy’s team helps relieve the administrative burden that can come from running any practice. Whether a new-start up, or bringing on a new provider, there are a lot of steps involved to make that happen to reduce lost revenue once that provider starts practicing.

We can even provide interim practice management to your group, if needed. Management changes, loss of key staff members, implementing new software or systems, consolidations or acquisitions, can all have an impact on your quality of care and ultimately on your bottom line. It’s not just about filling a vacant position for a short period of time, it’s about seamless support from start to finish. 99% of the work we do is remote and it works beautifully because of today’s technology. We view each assignment as an opportunity to help your organization become successful. We begin each engagement by understanding your needs so that organizational improvement will occur.


Tired of your current EMR?

Our Project Managers can help with the implementation and conversion of a new Electronic Medical Record.

Are you certain you are charging enough for your services?

Our Analysts can review your Charge Master to find out.

Is your billing being done timely, correctly and in such a way as to ensure proper coding and reimbursement?

Auditors can review charts to determine just that.

Experiencing management turnover that is impacting your cash flow?

Our Senior Consultants will assess and operationalize as interim management to assist your organization.

We provide daily operational guidance, along with weekly meetings and monthly AR reviews to keep staff on track with administrative functions, including all aspects of the front office and back office. We can assist for a short-term or long-term practice management staffing need.

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Billing Integrity Audits

Have you been audited by Medicare, BCBS, or commercial payors?

One of the many services Legacy Consulting provides is a Billing Integrity Audit. There are several layers to this kind of audit and we can provide all or just some of the pieces, depending on our client’s needs. These audits can prove useful to assure compliance and ensure your practice is being reimbursed properly for its services.

  • Every practice needs and confirmation that they are billing and coding correctly and compliantly– both for clinical reasons and reimbursement reasons. Our team can take a selection of charts per payor and per provider and do a thorough audit of each chart to confirm the proper documentation, correct coding, and appropriate billing levels were sent out on each claim.
  • Along with the documentation, we will review billing and coding to ensure your practice received the maximum reimbursement allowed, based on the clinical documentation. We will identify any gaps with modifiers, CPT codes or diagnosis codes, particularly with ICD-10, and ensure the appropriate billing levels were sent out on each claim.
  • We then provide an assessment of where we see deficiencies or areas of concern. We provide a suggested action plan and are available to help carry out any of the steps along the way with our Medical Billing Services. We also look at potential underpayments, overpayments, fee schedule discrepancies, EOB Reviews and provide ICD-10 training if needed as well.

Legacy Consulting Services can assist your practice by ensuring the claims that go out the door are correct and no money is being left on the table.

Contact us today to have us help your practice realize it’s collection potential!

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