With hospital and medical practice bottom lines rapidly eroding, there is an acute need for outside business expertise. With NextGen® Practice Solutions as your revenue cycle management (RCM) service partner, we'll:

• Analyze your current revenue cycle to determine issues that may be hindering your cash flow and growth
• Customize and adapt our services to meet your unique practice requirements
• Create workflow processes to streamline your operation and reduce your expenses
• Align your business office requirements with your clinical activities
• Identify specific examples of missed revenue, and educate your staff
• Jointly establish goals and metrics, and regularly provide you with detailed performance reports

• Billing and Collections
  We use our own set of internal controls, checks and balances, audits and reports. Our billing and collections approach addresses the entire revenue cycle, from functions that the practice performs, such as registration and charge capture, to those that we complete: claim submission, payment posting and accounts receivable management.

• Electronic Claims Submission
  We generate HIPAA-compliant insurance transactions to submit your insurance claims electronically to as many insurance payers as possible. We support the CMS-1500, UB-04 and ADA Dental Claim Forms. We also accommodate proprietary claim formats.

• Electronic Remittance & Payment Posting
  We ensure that your practice is receiving as many electronic payments as possible. Using the NextGen® Document Management System, we link an image of each EOB to the corresponding encounter at time of payment posting. This minimizes the need for storage of paper EOBs and places scanned EOBs at your fingertips for viewing or printing. Our experts focus on making sure your payments are posted accurately and promptly. We also use electronic remittance and digital lockboxes to post payments and capture specific denial information for management and tracking.

• Accounts Receivable Follow-Up
  We pride ourselves on our accounts receivable management methodology. We work with you to establish joint follow-up parameters, adjustment rules, and standards for account elevation. We understand which claims and payers are the most valuable to your practice, and we customize our follow-up activities accordingly.

• Customer Service
  Knowledgeable and courteous billing professionals answer patients' billing questions to minimize the need for practice staff to do so. Our staff has real-time access to your data and accounts. We measure and monitor key customer service statistics such as call wait times and abandonment rates so that we ensure high quality service.

• Account Management
  We assign an industry expert to your practice who meets regularly with you and your staff. They ensure that you understand your practice's revenue cycle performance, the drivers behind your performance, and any trends we may see. For larger clients, we also assign a senior Practice Solutions executive who meets with you frequently to review organization-wide revenue cycle trends and issues and adds strategic input to your revenue cycle related business decisions.

We believe when you've seen one practice's revenue cycle solution, you've seen one solution. So, with NextGen® Practice Solutions, you can choose to add any or all of our optional services to our core product

• Advanced Analytics
  We offer custom reporting capabilities and the ability to analyze and package, at specific frequencies, the sophisticated revenue cycle metrics that larger health care systems and organizations require.

• Charge Capture
  This service is for clients who want NextGen® Practice Solutions to enter their charges for them rather than enter them through their EHR or practice management system.

• Credentialing
  Credentialing is labor intensive for most practices, so NextGen® Practice Solutions has a team of people and the technology available to handle either one-time or on-going credentialing needs.

• AR Wind Down
  We can assist you with collecting accounts receivable that was incurred prior to your relationship with NextGen® Practice Solutions.

• Software Hosting and Support
  Let us host your NextGen® Practice Management or EHR application, or both if you have them. This relieves the practice of the associated expenses, hardware, overhead, and labor.

NextGen Practice Solutions maintains a proactive Compliance Program which includes a detailed written code of ethics and compliance plan, continuing education, active Compliance Committee, and a toll-free anonymous hotline which is answered by our outside legal counsel. The program includes annual employee training regarding our plan and compliance with all Federal, State, and local guidelines.

The Compliance Department checks all employees and provider customers against the OIG and State Web sites annually in order to assure that there are no providers or employees that have become ineligible to participate in the Medicare and Medicaid programs.

We also take pride in proactively providing our customers with regular information regarding compliance, including a monthly Compliance Newsletter (from a third party) and an internal newsletter to all of our customers on a monthly basis.

NextGen Healthcare's track record indicates a history of modifying our products and services as necessary to facilitate client compliance with the final, applicable HIPAA regulations. For example, Claredi, a leading independent HIPAA compliance testing and certification company has tested and certified NextGen Healthcare’s ANSI x12 healthcare claim transactions as HIPAA compliant. NextGen Healthcare adheres to all federally mandated application requirements as they apply to our products and marketplace.