--- title: News | Prime Care Technologies | cash flow description: cash flow | Timely updates from the long-term, post-acute care industry and Prime Care Technologies. --- [![PCT PCD Email Signature (524 x 102 px) (300 x 100 px) (1)](https://www.primecareholdings.com/hs-fs/hubfs/PCT%20%20PCD%20Email%20Signature%20(524%20x%20102%20px)%20(300%20x%20100%20px)%20(1).png?width=300&height=100&name=PCT%20%20PCD%20Email%20Signature%20(524%20x%20102%20px)%20(300%20x%20100%20px)%20(1).png) ](https://www.primecareholdings.com/prv) [![Request A Demo](https://no-cache.hubspot.com/cta/default/79917/f5e6168c-e0a4-45aa-912f-32a380cc04e5.png)](https://cta-redirect.hubspot.com/cta/redirect/79917/f5e6168c-e0a4-45aa-912f-32a380cc04e5) ###### 3 min read ## [How Well is Your Claims Management Solution Moving Cash Flow?](https://www.primecareholdings.com/news/claims-management-solution-cash-flow) By [Prime Care Tech Marketing](https://www.primecareholdings.com/news/author/prime-care-tech-marketing) on Fri, Dec 11, 2015 @ 06:58 PM **![Claims Management Cash flow](http://info.primecaretech.com/hubfs/iStock_000035332812_Small.jpg "Claims Management Cash flow")That claims management has an impact on cash flow cannot be denied.** But is your solution really working for you? First, let’s identify in what ways a claims management solution helps cash flow by converting into statements the questions found in our recent [primeCLAIMS quiz](http://www.primecaretech.com/claims-clearinghouse-quiz?__hssc=&__hstc=224280196.b0926af02e51a0ea314185440bd28fa6.1442020336952.1449688563351.1449694659380.38&hsCtaTracking=3effcf82-351d-47c0-8482-b89634722c4b%7Cdd36d330-4f18-45f4-8ac1-8598e59dab25), entitled, “Is Your Claims Clearinghouse a High Performer?” **Cash Flow**   **With your current solution you should be seeing cash flow improvements quarter over quarter.** We suggest setting specific goals tied to claims-to-cash improvement and review progress at least quarterly. Contributing directly to cash flow improvement is measured improvement in your claims acceptance rate. The clearinghouse you choose should be able to help your AR team significantly reduce claims rejections conveniently. Occasionally, payers may request changes to the claims your team submits. A clearinghouse should help you turn those claims around quickly. **Take a close look at your clearinghouse and the middleware[**[1]**](https://www.primecaretech.com/business-it-services-blog/-temporary-slug-c7f5bf78-762e-42c8-9d13-ea71a6b5225d#_ftn1) it uses.** We have learned from providers who use other clearinghouses that critically-needed application upgrades can take an unreasonably long period of time. Why? Because some clearinghouses do not own the middleware their application relies on and must wait for such changes. Owning the middleware certainly contributes to a quicker response to upgrade requests.  **We’ve mentioned this **[**before**](http://www.primecaretech.com/business-it-services-blog/clearinghouse-support-is-it-there-when-you-need-it)**, but with a clearinghouse experienced with post-acute payers** and their claims processing technicalities providers are more likely to see improved claims processing and fewer frustrations. Such a clearinghouse is more responsive to LTC provider needs and in some cases the clearinghouse can anticipate needs and be ahead of the upgrade curve. **Productivity & Labor Savings** **Considering turnover issues, the automated claims management solution needs to be intuitive** - easy to learn and use for newly-hired and less-experienced billers. Further, with customized train-the-trainer programs and implementation, the clearinghouse helps providers to get new-hires up and running quickly while reducing orientation and training costs.  ** ** **The clearinghouse application must be robust with simplified reimbursement workflows **and the users’ ability to manage claims submissions, denials, remits, DDE access, and HETS inquiries in a single portal. Further, being able to submit claims in batches reduces inefficient and costly steps. Should a payer reject a claim, the clearinghouse should be able to isolate the rejected claim and not reject the entire batch. Another example of possible key clearinghouse capabilities is the automatic identification and release of secondary claims. [Secondary claims](http://www.primecaretech.com/business-it-services-blog/taking-the-headaches-out-of-secondary-claims) are a significant part of revenue to be collected yet are likely most at risk for non-payment. **Near and dear to any CFO’s heart are reports.** Being able to view a dashboard of claims-related KPIs has proven valuable to provider management teams which can reinforce accountability throughout the entire claims management process. **Compliance** **From a strategic standpoint, having a clearinghouse partner** that keeps up with LTC-specific regulatory changes across the senior care continuum and communicates them to its provider partners is important. In primeCLAIMS, customers are able to view updates and notices in their dashboards – a convenient way to anticipate and prepare for changes. **Security** **Being in total control of who has access to which features, functionalities, and reports** gives providers the control they want over the claims flow process. Such security capabilities give corporate, region, and facility managers the flexibility they need to view all locations for which he or she is responsible in aggregate and individually. **Enterprise Effectiveness ** **Sometimes the term “enterprise class” is overused**, but in the case of claims processing, this term is meaningful. With some clearinghouses, management can only view claims’ status one facility at a time. Being able to aggregate (at the corporate or region level) and drill down to specific facilities in one portal gives managers both a high-level and, if they choose, an in-depth view of pending, outstanding, and paid claims. **A clearinghouse should not only upgrade** its application and best-practice recommendations based on regulatory and payer-specific changes, but also listen to current customer needs and requests to improve customer productivity. If the clearinghouse appears to be unresponsive or slow to respond, that should be a concern. **Conclusion** We recommend that you carefully evaluate your current claims management solution to see if it is effectively helping you move cash into the bank. It just makes cents. [[1]](https://www.primecaretech.com/business-it-services-blog/-temporary-slug-c7f5bf78-762e-42c8-9d13-ea71a6b5225d#_ftnref1) “Middleware is a general term for software that serves to "glue together" separate, often complex and already existing, programs. Some software components that are frequently connected with middleware include enterprise applications and Web services.” TechTarget, [http://searchsoa.techtarget.com/definition/middleware](http://searchsoa.techtarget.com/definition/middleware), Margaret Rouse [![Claims Process](https://no-cache.hubspot.com/cta/default/79917/1b138798-019b-4705-8c87-7e3f30c069b6.png)](https://cta-redirect.hubspot.com/cta/redirect/79917/1b138798-019b-4705-8c87-7e3f30c069b6) ###### Topics: [automated claims management](https://www.primecareholdings.com/news/topic/automated-claims-management) [cash flow](https://www.primecareholdings.com/news/topic/cash-flow) [clearinghouse](https://www.primecareholdings.com/news/topic/clearinghouse) [Medicare claims](https://www.primecareholdings.com/news/topic/medicare-claims) [claims](https://www.primecareholdings.com/news/topic/claims) [middleware](https://www.primecareholdings.com/news/topic/middleware) [claims submissions](https://www.primecareholdings.com/news/topic/claims-submissions) [secondary claims](https://www.primecareholdings.com/news/topic/secondary-claims) [reimbursement workflows](https://www.primecareholdings.com/news/topic/reimbursement-workflows) [application upgrades](https://www.primecareholdings.com/news/topic/application-upgrades) [compliance](https://www.primecareholdings.com/news/topic/compliance) [security](https://www.primecareholdings.com/news/topic/security) ###### 3 min read ## [Improve Cash Flow Visibility with Business Intelligence](https://www.primecareholdings.com/news/cash-flow-visibility-business-intelligence) By [Prime Care Tech Marketing](https://www.primecareholdings.com/news/author/prime-care-tech-marketing) on Tue, Nov 10, 2015 @ 11:30 PM ![Claims Processing](http://info.primecaretech.com/hubfs/Boat_Lake2.0.jpg "Boat_Lake2.0")“I believe people are like boats.” With that I’ve started many a seminar and webcast. After a brief pause, I relieve the tension by saying, “They toot the loudest when they’re in a fog.” Ambiguity, tardy information, and just plain situational ignorance can keep many a decision-maker in a fog. However, because of the critical need to know how much and when cash will be flowing into and out of the bank, CFOs need crystal clear visibility. And business Intelligence dispels the haze and sharpens the perception of what is happening. From cash collections and revenue projections to labor and non-labor spend management, operations and finance executives alike can know almost up to the minute how much cash is flowing in and how much is flowing out. ### **Business Intelligence makes it happen** As we have discussed in [previous blogs](http://www.primecaretech.com/business-it-services-blog/benefits-of-businessintelligence-to-long-term-care-providers), Business Intelligence (BI) has become *the* go-to tool to help managers keep their fingers on their business’s multiple pulses all in one convenient easy-to-view location. For LTPAC providers, this amounts to such Key Performance Indicators (KPIs) as census, cash, accounts receivable, labor and non-labor spend, clinical, and other information. Roll up. Drill down. It doesn’t matter. CFOs can glimpse a consolidated view of KPIs important to them and then drill down as deep as they need to track, trend, and act. It’s real time and it’s highly effective. How? BI makes information visible at all levels within the organization simultaneously. And visibility drives accountability But let’s limit this conversation to cash flow ### **Turning revenue into cash in the bank** Let’s explore a day-in-the-life-of one of a CFO who uses BI to monitor and hold accountable those responsible for keeping the cash flow steady and predictable. It’s mid-month and after logging into the BI tool (in our customers’ case, primeVIEW), the CFO, we’ll call him, “Craig”, reviews the tiles he’s configured for his home page displaying what to him are the critical KPIs. From there he clicks on the Cash/AR tab to view such information as: - The current month collections-to-goals performance with 12-month trending - What’s been collected and deposited each day by payer type for the current month, recent quarter, and year-to-date (Remember. He can view a corporate summary or drill down to a region or facility level.) - How each facility or region ranks compared to their company peers by payer type - The status of each facilities aging with payer type drilldown capabilities - The Days Sales Outstanding (DSO) over a specified period of time - How revenue is trending by payer typ Craig notices that the South region is falling short of its MTD collections through the 15th of the month. He calls Melissa, one of his veteran regional managers, and invites her to open up primeVIEW to discuss these outliers and what her staff can do today to right the regional ship and get it back on course by the next collection benchmark which is the 20th. Melissa reports that she and her staff have been working with Facilities A and D since noticing the slowdown in collections on the 10th. She assures Craig that her team is confident that these facilities will reach the month-end harbor very close to their goals ### **Financial performance** After concluding the call, Craig clicks on the financial tab to check on current revenues generated compared to budgeted projections by region as well as by facility by payer type. He further reviews revenue by occupancy by day, by payer, and by service. Convinced that the company is on track to meet goals and, in a couple of facilities, to exceed goals, Craig then turns his attention to the bad debt allowance status by facility as well as month-to-month trending. He makes a note to himself to address this issue in the next meeting with his corporate AR manager ### **Conclusion – Visibility is more than just clarity of sight** Because of BI, cash flow visibility is current, communication is specific, and required action is timely. Visibility encourages accountability and fosters real results. [![Business Intelligence](https://no-cache.hubspot.com/cta/default/79917/ec0aaaba-1064-4cde-9f32-6c31a2200790.png)](https://cta-redirect.hubspot.com/cta/redirect/79917/ec0aaaba-1064-4cde-9f32-6c31a2200790) ###### Topics: [DSO](https://www.primecareholdings.com/news/topic/dso) [business intelligence](https://www.primecareholdings.com/news/topic/business-intelligence) [Key Performance Indicators](https://www.primecareholdings.com/news/topic/key-performance-indicators) [cash flow](https://www.primecareholdings.com/news/topic/cash-flow) [BI](https://www.primecareholdings.com/news/topic/bi) [ar](https://www.primecareholdings.com/news/topic/ar) [days sales outstanding](https://www.primecareholdings.com/news/topic/days-sales-outstanding) [KPIs](https://www.primecareholdings.com/news/topic/kpis) [CFO](https://www.primecareholdings.com/news/topic/cfo) [LTPAC providers](https://www.primecareholdings.com/news/topic/ltpac-providers) ###### 3 min read ## [Avoiding Unintentional Fraud](https://www.primecareholdings.com/news/bid/76079/Avoiding-Unintentional-Fraud) By [Prime Care Tech Marketing](https://www.primecareholdings.com/news/author/prime-care-tech-marketing) on Fri, Mar 16, 2012 @ 03:49 PM ![Avoid Medicare Fraud Investigations](http://info.primecaretech.com/hs-fs/hub/79917/file-15696459-jpg/images/istock_000008076253xsmall-resized-600.jpg)**Ignorance is no excuse.** Over the last few months, like me, I’m sure you’ve seen headlines and read articles about the federal crackdown on Medicare and Medicaid fraud. Millions of dollars have been identified as fraudulently paid for services either not rendered or with limited justification. I acknowledge that there are unscrupulous practitioners and providers out there who should be identified, indicted, convicted, and sentenced to the fullest extent the law allows. However, while I don’t have the numbers, I wonder to what extend “fraud” was committed by those who unwittingly engage in poor billing practices, such as miscoding and/or absence of support documentation for procedures provided. The old adage, that if you didn’t document it, it didn’t happen, may put providers and practitioners at risk of investigation and indictment with all the attendant negative results, such as loss of reputation, decline in confidence, and possibly business failure. **If this falls within the reasonable realm of plausible possibility, I have to scratch my head and wonder why. **Why place your business and your future at risk, when you don’t have to? Once again, and you have to admit that this blog is consistent when it comes to waving the IT banner, IT can come to the rescue. Imagine the peace of mind you could have while reducing your DSO, assuming you are at risk not for lack of integrity, but credibility, if your organization had a billing and claims management system that would file clean claims each and every time.**** **Such an automated revenue cycle management system exists, specifically designed for long term care providers.** Imagine a system comprised of a comprehensive and configurable user-friendly web portal to manage claims throughout the submission process, with functions for loading, reviewing, editing, and tracking claims online. With this portal, providers can fully leverage enterprise-level security and permissions with user-definable roles to satisfy their specific claims processing practices. As part of a complete health care transaction solution, providers can submit, monitor, edit claims, and review their claims on-line. **Key benefits of the ProClaim Partner’s application**: - **Increased revenue stream and reduced DSO** through quick claims turn-around and real-time claims management reporting viewable through a user-defined digital dashboard - **Smoother claims flow** through direct connections with providers, trading partners, and value-added networks - **Eliminating avoidable payment delays** by increasing successful first-pass rates, tracking claims, and automatically checking claim status - **Reduced transaction fees and paper handling costs** by enabling direct connection with providers and payers - **Decreased operations costs** through automated handling of routine questions and documentation requests associated with eligibility, claims status, and referrals - **Preserving investments in existing systems** by offering an off-the-shelf claims management application that easily interfaces with existing adjudication, financial, and membership systems - **Reduced risk** through its robust user audit functionality **Providers would be well rewarded for looking into it.** At times like these and under this “gotcha” environment of fraud crackdown, doing billing right certainly has its virtues. But a system is only as good as the workflow that leads to the filing of claims – preadmissions screening and documentation; admissions documentation; clinical documentation; therapy services documentation; proper coding; charges compiled; and claims created, scrubbed, triple checked, filed, and monitored. All are critical components of the workflow and are at risk of vital data and information leakage. **In the next blog**, we’ll discuss some of these workflow components which are considered industry best practices. **Question**: What solid claims management practices have you observed or implemented? ###### Topics: [DSO](https://www.primecareholdings.com/news/topic/dso) [automated claims management](https://www.primecareholdings.com/news/topic/automated-claims-management) [workflow](https://www.primecareholdings.com/news/topic/workflow) [Medicare fraud](https://www.primecareholdings.com/news/topic/medicare-fraud) [Medicaid fraud](https://www.primecareholdings.com/news/topic/medicaid-fraud) [automated revenue cycle management system](https://www.primecareholdings.com/news/topic/automated-revenue-cycle-management-system) [cash flow](https://www.primecareholdings.com/news/topic/cash-flow) [avoidable payment delays](https://www.primecareholdings.com/news/topic/avoidable-payment-delays) [increased revenue stream](https://www.primecareholdings.com/news/topic/increased-revenue-stream) [reduced DSO](https://www.primecareholdings.com/news/topic/reduced-dso) [All posts](https://www.primecareholdings.com/news/all) ### Sign up for updates ### Featured ### Posts by Tag - 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