Revenue Cycle Management
VWA provides a suite of services to the healthcare industry, helping healthcare providers manage front end processes such as new patient enrollment and eligibility verification, while improving back office functions such as statement generation, patient collections, insurance rebilling.
Our strategy is to provide our clients with best in class service and a strong value proposition.
Our long-term history of success and continual expansion into the global medical servicing and collections allows us to provide a combination of industry-leading domain experience and allows our clients to benefit from our commitment to deliver value through increased recoveries, streamlined escalations and advanced reporting.
VWA is a member of the Healthcare Finance & Management Association and operates as a HIPAA compliant organization, routinely conducting HIPAA Compliance audits, training and re-education to ensure privacy of all patient information.
Medical Collections - VWA's expertly-trained collectors manage your patient collections accounts with care. Our collectors establish contact with your patients and work with them to bring resolution to their accounts. During the collection process, we identify the responsible party and feedback to you any new or updated insurance information which results in getting your claims paid.
Statements- VWA's Statement and invoicing services provides consolidated billing for multiple billing channels which decreases patient questions, improves invoice acceptance, increases efficiencies for existing staff by taking away patient questions, and increases cash flow.
Insurance Collections - To ensure quality, VWA passes each client's account through 4 distinct phases -- Carrier Contact, Carrier Response, Decision and Action, Analysis -- with each task analyzed for quality improvement and predictive forecasting.
Initially, each account is reviewed to confirm the claim was submitted, that the claims data is complete and accurate, and for any carrier replies that may not have been auctioned. If any discrepancies are identified the claim is re-billed with the proper adjustments. For quality control all issues identified during the account review phase are categorized and quantified to assist our clients in addressing front end processing.
- Carrier contact
The next phase of the cycle is direct contact with the carriers to determine the status of a submitted claim. It is during this phase that eligibility is confirmed, that receipt of the claim is confirmed by the carrier, and any updates as to the status of the claim are gathered. All information is catalogued for review by VWA and our clients. The carrier contact phase is the most important in increasing yields from the portfolio. It is essential that claims are followed up on timely and proper responses are submitted.
- Carrier Response
VWA recognizes 2 categories of carrier response - Payment and Denial. Payment responses are noted, either with the promise to pay date and amount for forecasting, or with the previously paid check information for research into a missing remit. VWA attempts to capture the reason for the delayed payment if carrier will provide. This information is relayed back to our client to assist in modifying front end billing processes that may result in higher and quicker initial payment processing.
- Decision and Action
All denials are categorized for a decision and action process. Standard categories include Eligibility, Exclusions & Limitations, Timely Filing, Subrogation, and Deductible. Each category then has its own thresholds for the decision process - Accept Denial/Close Claim, Accept Denial/Patient Responsibility, or Appeal Claim. Patient responsibility claims become a collection item while Appealed Claims are processed back through the workflow.
- Analysis
The final phase is a constant evaluation of the results of each stage and the ultimate outcomes of each claim. By providing step-by-step analytics regarding the process VWA identifies critical bottlenecks that slow or block payment as well as process inefficiencies that can be modified to create a better overall process. These analytics are shared with the client so they have visibility to the issues that VWA uncovers and are themselves able to assist in the resolution process.
VWA incorporates technology throughout the process, making us the leader in medical collections outsourcing services. In fact, VWA introduced web services and online placements to the industry. Our proprietary software has been researched and developed with hands-on experts who know exactly what functionality a collections system needs to quickly locate, track, assess, code, and collect on a claim. We offer premier security, management tools and reporting and real-time online tracking.
Our Medical Collection program has no start up fees to begin the service. VWA will absorb all start up costs, skip tracing, and other steps required to collect on a claim.