Solutions

CAPRN takes a total view of your current situation to analyze and recommend the most efficient approach to maximize the financial well-being of your practice. The overall philosophy is based on the famous Deming Cycle for quality systems implementation, namely:
Plan - Do - Check - Act or PDCA.

ACT:
Analyze the differences to determine
their cause. Each will be part of either
one or more of the P-D-C-A steps.
Determine where to
apply changes that
will include
improvement. When a
pass through these
four steps does not
result in the need to
improve, refine the
scope to which PDCA
is applied until there is
a plan that involves
improvement.

Check:
Measure the new
processes and
compare the
results against the
expected results to
ascertain any
differences.

PLAN:
Establish the objectives and processes
necessary to deliver results in accordance
with the expected output. By making the

expected output the focus, it differs from what would be otherwise in that the completeness and
accuracy of the
specification is also part of the improvement.

DO:
Implement the new
processes.

This cycle is adapted to the activities to be performed for Revenue Management for Physician Services, as follows:

Phase I Define & Analyze Process	Phase II Implement, Redefine, Adjust	Phase III Monitor & Continuous Improvement
Review Insurance contracts Review key performance metrics Review current claim status Review receivables aging Review front-office processes Analyze and recommend process improvements, receivables recovery plan and establish daily communication plan	Implement the accepted process improvements Enhance automated rules implementation to minimize charge entry errors before submission Ensure 48-72 hours turnaround for claim submissions Ensure regular payment postings and follow-up of denied / rejected claims	Implement collaboration software for constant structured communication between all stakeholders Continuous monitoring of daily activities Analyze performance of insurance companies and advise physicians Track errors in operations to enable further improvements