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Patient Access and Revenue Cycle Solutions
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We partner with our clients to develop customized solutions that optimize the entire revenue cycle continuum. Our flexible and scalable technology, coupled with our team of revenue cycle experts allow us to work in the client's system or process independently. ESI's patient access and revenue cycle solutions have resulted in enrollment and coverage for more than 1.5 million patients-and otherwise unrealized revenue of more than $8 billion.
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Service
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Description
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Registration Data
Confirmation
ROI: $3.24 return to $1.00 ESI fee
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Real-time patient registration data validation and critical error notifications. Works with current patient registration system. Based on industry standard business rules and customized business rules.
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Eligibility and
Benefits Verification
Eligibility Re-mining
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Real-time insurance and benefits verification.
Batch solution to retrospectively identify initial self-pay patients that have eligible third party coverage.
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Address and Patient
Data Verification
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Real-time or batch address verification using key patient demographics including DOB, SSN, DOD, etc.
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Eligibility Tracking Tool
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ASP management tool for Medicaid or SSI/SSDI eligibility, LOL and charity care qualification application preparation and submission processing.
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AR Recovery
ROI: $6.67 return to $1.00 ESI fee
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Follow-up on unpaid claims to all third party payers;correct and resubmit;utilize customized, pre-defined work lists based on payer, value, and age of accounts.
Medicare Secondary Payer - create, follow-up, and resolve Medicare secondary claims.
Legacy System Conversion - follow-up and collect on legacy system AR allowing client staff to focus on system conversion and current AR.
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Ambulatory Coding
and Claims Work-flow
ROI: $8.34 return to $1.00 ESI fee
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Create electronic claims using registration and charge data, with coding based on clincial records. Rejections are monitored, corrected, and resubmitted.
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Schedule An ESI Rx History™ Demo
| "For the past 20 years, the Cook County Health and Hospitals System (CCHHS) has utilized ESI's patient eligibility services, eligibility re-mining, pharmacy billing, and ambulatory coding and billing services to generate over $1 billion of additional revenue for the CCHHS. The CCHHS has benefited greatly from the high level of customer service and dedication of the ESI organization." |
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John R. Morales, CPA
Chief Financial Officer/Deputy Director
John H. Stroger, Jr. Hospital of Cook County |
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