The RevRunner suite is a collection of integrated financial clearance connectivity services designed to work with your existing technology investments, utilizing current staff and requiring nominal IT support. In its entirety, or in carefully integrated bundles, RevRunner delivers the information you need to support the financial health of your system and your patients, while also addressing the business realities of maintaining mission goals.

Patient Verification

The financial health of the patient begins with developing a full patient financial profile. By ensuring you have properly validated the patient's identity and available financial resources, you can begin to have the necessary discussions regarding their healthcare services and payment options. The following tools were developed to work in tandem to deliver the most comprehensive patient verification product available.

(Flat-Fee) Eligibility Verification
RevRunner provides the next-generation of eligibility verification technology. Integrate eligibility verification, in real-time or batch, directly into your HIS registration system to eliminate “dual entry” of information by your staff and ensure that every patient encounter is automatically reviewed for third-party coverage. Flat-fee pricing eliminates artificial caps on eligibility transactions, enabling you to do multiple checks for insurance coverage throughout the revenue cycle on every patient encounter. Direct-to-payer connections deliver the most accurate and up-to-date information available.

Patient ID and Address Validation
Verify patient demographic information using third-party data sources to ensure accuracy of eligibility verification efforts, minimize unnecessary denials, reduce return mail, and decrease opportunity for patient identity fraud.

Propensity-to-Pay
Discretely determine both a patient’s ability to pay and their probability to pay. Allow your staff to focus efforts on collectible accounts and identify accounts best suited for third-party collection services.

Medical Necessity
Provides accurate outpatient medical necessity compliance checks at pre-service or point-of-service. Also applies Correct Coding Initiative (CCI) and Outpatient Code Editor (OCE) edits. The system supports open communication with patients regarding financial obligations prior to treatment by automatically producing and storing Advanced Beneficiary Notices (ABNs).

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Pre-Service Collection

Maximizing cash collections and accelerating reimbursement at the front-end of the revenue cycle requires automated tools that provide a clear and credible view of data from multiple sources.

Bill Estimation
Combines comprehensive eligibility information from payers with detailed information related to hospital pricing contracts to credibly estimate patient charges. Calculates patient financial responsibility using payer specific contract details and the patient’s actual year-to-date benefits. By integrating hospital contract data with real-time information from payers, it accurately calculates the patient’s share of the cost, allowing the hospital to collect payment or arrange a payment schedule prior to service delivery.

Pay Manager
Determines patient ability-to-pay, recommends point-of-service collection amount and suggests a monthly payment plan based on hospital charity discount and collection policies.

eCashiering
Provides the end-user with a logical workflow and common user interface for all aspects of securing payment from the patient during pre-registration or registration. Integrated with RevRunner’s Bill Estimation Pay Manager workflow to ensure maximization of point-of-service cash collections.

Automated Dialing
Through automated outbound voice technology, verifies all insurance information by obtaining the patient responsibility portion, securing all authorizations and confirming the scheduled service with the patient. It also will accelerate a healthcare system’s revenue cycle by working with the patient to provide payment or creating a payment arrangement at the time of service. It also assists in the pre-authorization process by identifying accounts requiring pre-authorization and grouping them by payer so multiple accounts can be handled during a single call and recording the call for future reference, if necessary.

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Financial Advocacy

To meet the increased efficiencies required to ensure overall financial health, technology solutions are necessary to ensure hospitals can extend their mission and better serve their communities. The following tools were developed to assist hospitals with serving as advocate for the financial health of the patient as part of the overall care experience.

NEW! Charity Compliance Manager^SM
Charity Compliance Manager enables hospitals to support the operational requirements associated with IRS Form 990, Schedule H regarding the newly established definition of community benefit and the additional tracking and reporting expected. A Charity Predictor Score^SM enables pre-service automated classification of patients that may be considered presumptive charity eligible, as well as retrospective reclassification of bad debt accounts. Charity Compliance Manager also supports completing charity applications online, as well as providing documentation for Form 990 reporting related to charity care. Download the product overview here...

Financial Assistance Screening
Enable your registration staff, via a brief financial aid triage interview, to easily and uniformly assess each patient’s potential qualification for all available financial assistance funding sources (e.g., Medicaid, hospital charity, SSI Disability, etc.). Increase net new revenue through identification of funding sources otherwise missed and properly classify patients into appropriate financial categories.

Financial Assistance Enrollment
Automate the process of enrolling patients into applicable financial assistance programs or charity care via a comprehensive online financial intake interview, as well as complete online financial aid enrollment application(s). Generate hard and soft copies of enrollment forms and manage the entire application enrollment process online - from initial patient intake interview, through final disposition (i.e., approved or denied application).

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For More Info

To schedule a demonstration or to purchase any of our products, please contact
RelayHealth direct at (888) 487-8010 x2246, or send an email message to sales.