RMPayment Variance Reporting

Plans, Pricing and Details.

Payment Variance Reporting - Powered by Revenue Masters Healthcare Contract Management & Modeling

Ensuring every claim is adjudicated correctly calculated according to your payer contracts. It can be especially challenging for CAH, smaller community hospitals and physician groups. Even if you outsource your billing do you have a check and balance to make sure all payments are accurate per your payer contracts and they identify those incorrectly paid or correctly denied to capture those monies.

When doing billing in-house, most providers are trying to Identify underpayments and wrongful denials with home grown spreadsheets and Word docs. They also often utilize “ Spot Checking” because it is not practical to check every single claim. The option to buy software contract management systems to do this are out of reach financially for just the set up fees plus large annual high five and six figure annual subscriptions.

Then factor in the dedicated staff to operate the software and having multiple staff trained for for redundant back-up. It also requires a whole new work flow to train your team on.

What if there was a better way:

No contract modeling knowledge necessary

No maintaining contract updates

No change in your current workflow 

A monthly fee of the fraction of the cost of a single employee 

Delivered via a HIPAA compliant software application 

A money back guarantee 

 

Book An Intro Call
 

Here's how it works

 

Every weekday your identified staff will receive emailed RMPayment Variance Report that gives your team the open variances to work on.

Read the report and utilize your workflow to enter in accounts with variances to appeal and overturn.

In the report you will know that there was a variance from what should have been paid along with the information to use to place in your appeal letter to overturn the variance.

Are you outsourcing billing? Use the report as a check up on your outsource company or have the report sent to both your outsource company staff for them to utilize.

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Here's How to Set-it Up


Sign a BAA and an affordable subscription agreement.

Supply us with your payer contracts and tables

Supply a staff member to work with us to sign off that each contract was both interpreted and calculated correctly.

Supply a staff member to work with us to sign off that each contract was both interpreted and calculated correctly.

A closer look at your sample daily email for payment variance reporting

 

With Revenue Masters subscription, you will receive a daily email with your payment variance report. The email will include the information to the right.

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Questions

FAQs


Got a question? We've got answers. 

Who models and updates the contracts, rates and terms?
The Revenue Masters team will model all payer contracts and will also maintain the payer updates. We become an extension of your contract management team.
How do we know everyday what the new payment variances are to work and updated past payment variances?
Your email includes your daily link to download new payment variances for the previous day’s payment or denial posting as well as you are able to download a weekly or monthly payment variance report as well.
Security
HITRUST security, The software in HITRUST certified for the highest level of HIPAA compliance.
What data is required from us and how do you obtain it?
We will ask for your payer contracts and any data tables such as fee schedules and ASC groups as well as work with your team to obtain the EDI 837 & 835 files.
Can we include our paper claims be imported?
Yes, we can include paper claims and flat files to connect to and pick up automatically nightly in addition to EDI files.
How do we know the contracts are modeled correctly?
Once we have modeled all your contracts we will provide you with a payer allowable validation report for you to review and approve.
How are the contract rates and terms updated?
For Medicare and Medicaid we will update automatically once updates are available. With your managed care payers we will update when you provide us with the updated payer rates. We can access payer portal if access is granted to pull reimbursement tables going forward. Additionally, we will reach out to you 30 days prior to the contract end date as we monitor when we are to expect new payer rates.
Why should we model for Medicare and Medicaid?
This reimbursement can be a challege to model manually when you need to incorporate the reimbursement for your hospitals, clinics, and physician as they all have different rates and reimbursement tables that should be accessed.
What denials information is included?
We will provide a list of denied claims wherein there are specific denial 835 remittance CAS codes as well as line item denial.
Why is it so much less expensive than other contract management solutions?
Our software solution was built cloud first with today’s technology. There’s no legacy code to maintatin so it’s faster to make changes and launch for new clients like you.
What contracts are not able to be modeled?
We will model all of your payer contracts and rates. There has not been a contract we have been unable to model.
How do we add new contract after we launch?
Notify project manager by providing change request form with contract and reimbursement tables.
Who helps get us set up?
Typical setup includes a team of project manager, EDI support & security, and 2 contract modelers.
What ongoing support is there?
Support is from our U.S. offices 8:00am - 5:00PM Pacific Standard Time Monday - Friday. Support is unlimited.
What’s our ROI (Return on Investment)?
Your ROI is dependent upon your current processes. Our clients typically get anywhere from a 5X- 12X return on investment and some have identified millions in collectable new revenue.
Who receives the daily RMPayment Variance Report email?
Any management or staff who will work the payment variances identified. You can also set-up for an outside billing office to receive the report.
Do you offer any other add-ons or services?
We offer full workflow software and also contingency payment recovery services for those who qualify. We also offer contract comparison analysis for contract negotiations.
Can you import into our HIS system or have an API?
Yes we can import if your HIS system allows it with our RM API.
Do you help with payer contract negotiation?
Yes, we offer contract simulation which will compare current contract to proposed contract terms.
What is the money back guarantee?
Within 10 days after launch if you cancel for any reason all monies paid to date will be refunded.
How long is our contract for with Revenue Masters?
Free set-up accounts require a one year agreement. Longer agreements are available if desired.