Designed to improve reimbursement for self-pay accounts.

ConversionPlus® FOR CHC's

SELF-PAYS? NO INSURANCE? NO PROBLEM!

ConversionPlus® is a suite of services that can improve your reimbursement for self-pay accounts. With no intrusive installations or impact to your workflow, our automated system provides a cost-effective solution that yields immediate cash flow. Best of all, our no-cost evaluation enables you to see actual results with your live data before you decide.

A Step-by-Step Look at ConversionPlus®

1: New Eligibility Check
We check eligibility for self-pay and sliding fee encounters and routinely find a significant percentage have insurance which can be billed immediately.

2: Lookback Eligibility check
This is a daily automated search for retroactive coverage on all non-billable encounters. You are immediately notified with details when our system discovers encounters that have transitioned from non-billable to billable. This maximizes the likelihood of billing within timely filing limits.

3: Master Patient Index
Results of all eligibility checks are used to populate/update our MPI – one record per patient. We use this database to fill in gaps in new and lookback transactions before we check eligibility.

4: Encounter warehouse
Every patient encounter is stored and updated as changes in eligibility occur. We include the history of these changes in each eligibility report (New and Lookback Eligibility).

5: Roster refresh
Clients provide patient rosters from Managed Care Organizations that often have more complete data than the original self-pay lists. We use this data to update the Master Patient Index, improving conversion rates for all eligibility checks.

6: Capitation Payment Reconciliation
Payments listed in MCO’s capitation payment report are associated with accounts listed in a recent roster from the same MCO. This enables clients to track actual capitation payments against expectations.

 

FREE EVALUATION OF YOUR LIVE DATA

Our no-cost evaluation enables you to see actual results with your live data before you decide.
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MEASURABLE RESULTS. EXAMPLE FROM ACTUAL CHC (2017):

Self-pay accounts
analyzed: 92,032
Insurance found:
8,018 (9%)
Total new billable acct.
balances: $2,046,872

COMMUNITY HEALTH CENTERS ARE IMPORTANT TO US

CHC’s are the nation’s largest source of comprehensive primary care for medically underserved communities. Under the Affordable Care Act (ACA), increased patient revenues due to the expansion of Medicaid and private health insurance, along with increased direct federal investment in the program, have led to growth in the number of health centers and their capacity to provide services.

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