Rycan Revenue Cycle
Management Solutions Overview
Rycan Revenue Cycle Management
Solutions (RCM) Overview
Target audience:
Evident and Healthland
Recommended for: Executive Financial / Accounting Business Office HIM Information Systems Registration
Session Presenters:
• Jody HeardIndustry Marketing Director Business and IT Solutions
• Jamie Hodge
Learning Objectives
Gain an Introduction to Rycan
and Rycan’s Solutions
Rycan Overview
• A leader in healthcare Revenue Cycle Solutions for
over 30 years.
• Built our reputation by providing best-of-breed
software encompassed by a level of customer support that is unparalleled in the healthcare industry.
• Rycan’s Solutions enable healthcare providers of all
What Differentiates Rycan
• The most important distinction between Rycan and
other revenue cycle software vendors, is our approach to our solutions.
• Rycan builds best-of-breed software solutions. • Rycan determined early on that it would not try to
compete with the hundreds of vendors who build or rebrand anemic products that were designed to offer just enough functionality, to be sold as a program.
• Rycan offers software solutions that were designed,
Rycan Overview – Market Trends
• This devotion to providing cutting edge technology is
especially important in today’s difficult financial times where Revenue Cycle prowess is no longer a luxury, it is a requirement.
• Providers today face an increasing array of challenges
including:
• Decreasing margins;
• Increasing denials and Bad Debt; • Growing cash flow shortages;
Rycan Overview – Market Trends
• Reimbursement methods and models are changing at a
faster pace than ever before.
• Added to that is the fact that most providers have seen
their patients become their largest payer as a result of High-Deductible Health Plans.
Quality of
Care Accountable Care Organizations (ACOs)
Rycan Overview
• Through our hands-on approach and direct partnership
with our clients, Rycan’s suite of Revenue Cycle
Rycan Overview
• Our Solutions include:
• Patient Liability Estimates • Eligibility Verification
• Claim Scrubbing and Submission • Medicare Direct • Medicare Navigator • Claim Status • ERA Retrieval • Remittance Management • Deposit Reconcile
• Denial and Audit Management
• ESMD
Patient Liability Estimates
• High Deductible Health Plans have been the single
greatest contributor to many healthcare organization’s rise in Bad Debt.
• They have also been one of the largest drivers behind
sweeping process changes in most organizations’ registration departments.
• Front-end collections have become standard for most
healthcare providers.
• Shopping around and price comparisons are becoming
Patient Liability Estimates
• Rycan’s Patient Liability Estimates Module resolves
both of these issues by calculating a statistical average of your organization’s historical claim and remittance data, factoring the patient’s insurance information and applying any applicable discounts to provide accurate, up to date, estimates of the patient’s out-of-pocket expenses before the time of service.
• This information can be utilized to reduce your Bad
Debt by implementing a front-end collections process as well as improve patient satisfaction by enabling
Eligibility Verification
• Healthcare providers face an array of denied claims
everyday in their business offices. A significant portion of these can be traced back to the registration process and inaccurate insurance information.
• Having incorrect insurance information on a claim
Eligibility Verification
• Rycan’s Eligibility Verification Solution enables your
Claim Scrubbing and Submission
• Growing cash flow shortages are driving many
providers to scrutinize delays to their billing process.
• The sooner that a claim is submitted to the payer and
the more accurate the information on that claim, the sooner payment is received.
• Organizations are becoming keenly aware of the
immense cost of labor and resources involved in
Claim Scrubbing and Submission
• These factors are driving many organizations away
from the simple pass-through clearinghouses of the past and towards full-featured claim scrubbers with deep content validation.
• Automatically identifying and correcting claim billing
Claim Scrubbing and Submission
• Rycan’s Claim Scrubbing and Submission Solution is
superior to that of the other clearinghouses that you will see in this industry because it is truly a
full-featured software solution designed to ensure your claims are billed quickly and accurately.
• One of Rycan’s largest differentiators, is the degree to
Claim Scrubbing and Submission
• Further enhancing Rycan’s built-in edits, your staff
have the ability to create their own, customized edits real-time within the system enabling you to custom tailor your claim submission process and instantly adapt to payer and billing changes.
• In addition to this deep content validation, Rycan’s
workflow tools automate and simplify your staff’s day-to-day activities including:
• Secondary Billing / COB Enrichment
• Claim Attachments (electronic and paper) • Medicare Shadow Claims
ERA Retrieval and Remittance Management
• The requirement to streamline and accelerate the
posting process has driven most facilities to embrace electronic posting of remittance data.
• However, obscurities in the file specifications and
minimal enforcement of payer compliance has caused many organizations to struggle with electronically
ERA Retrieval and Remittance Management
• Rycan’s remittance solutions not only automate the
process of retrieving electronic remittance files from the hundreds of payers that you do business with, but also scrub and normalize that data ensuring that your organization will be able to post that information to your host system.
• As with Claim Scrubbing and Submission, these edits
Denial and Audit Management
• Ever increasingly complex reimbursement models are
causing an increase in denials across the industry.
• Organizations are quickly realizing that the sheer
Denial and Audit Management
• Added to this is the fact that governmental and payer
audits have gone viral.
• RACs are Back
• Medicare Advantage, Medicaid, and Commercial
payer audits are on the rise
• Across the nation, healthcare audit teams are seeing a
Denial and Audit Management
• Rycan’s Denial and Audit Management Solution ensures
that every denied claim is identified and assigned to
the appropriate staff member, providing them the tools necessary to appeal and resolve the problem claim.
• Root cause analysis, denied claim follow-up and claim
resolution are simplified with Rycan’s automated workflow tools.
• Audited claims are easily tracked, appealed, and
Contract Management
• Reimbursement complexity is growing by the day.
• This complexity and the sheer volume of transactions
your organization processes makes it impossible to manually verify payer contract compliance for every claim.
• The introduction of new payment methodologies like
APR-DRGs and EAPGs opens the door even wider for payment variances and payer mistakes.
• Electronic Contract Management systems have become
Contract Management
• Rycan’s Contract Management Solution empowers you
to take control of your contracts.
• Predict Payments on claims before they are paid
• Prospective pricing functionality provides accurate,
instantaneous analysis of your cash flow, detailing expected payments as well as anticipated write-offs
• Verify every claim was paid correctly
• Retrospective pricing validates that you received
Contract Management
• Model payer contracts during negotiations
• Modeling your contracts within Rycan enables you to
level the playing field during negotiations.
• Entering the proposed contract terms into the
TruBridge and Rycan
• Integration is already underway between Rycan’s
Revenue Cycle Software Solutions and the advanced knowledge, expertise, and processes of TruBridge’s Services and Staff.
• The integration of these two industry leading
organizations enables the creation of a single,
seamless solution which spans the entire spectrum from a fully outsourced business office to an
Additional Rycan Education
•
Claim Scrubbing and Submission
• Thursday, May 19 at 10:30 a.m.
•
Patient Liability Estimates and
Contract Management
• Thursday, May 19 at 2 p.m.
