Ascent^®

Achieve Revenue Cycle Success

The Ascent® financial management solution provides a comprehensive approach to the challenges of revenue cycle management and managed care by addressing operational, strategic, and related workflow processes. With Ascent, you can control the factors critical to your financial success: pre-authorization, denial management, contracting, reimbursement, resource and process improvement.

For strategic decision making, the system's integrated database gives you access to all of the managed care information you need from a single source.

Ascent helps hospitals:

• Address revenue cycle operational and strategic challenges across functional areas
• Streamline revenue cycle workflow
• Ensure accurate payment of claims
• Enable better informed payer contract negotiations
• Deliver cost-effective healthcare without sacrificing quality

Advantages:

• Notify hospital personnel of revenue cycle triggers affecting reimbursement and profitability


• Track appeals and outcomes and recover underpayments on historical and current accounts


• Ensure accurate exclusionary reimbursement terms or stop-loss with expected reimbursement calculations for complex contracts using detail transactions


• Identify recurring problematic terms / trends for contracts / payers


• Explain the breakdown of expected reimbursement to payers with a summary bill of record report


• Access contract pre-certification, authorization, and notification requirements to verify patient eligibility and financial authorization

Ensure accurate payment of claims and profitable contract negotiations with a powerful managed-care contract modeling capability

• Gain leverage to negotiate the most profitable outcome from proposed payer contract changes


• Isolate patient and payer populations and create "what if" scenario models


• Forecast expected reimbursement resulting from proposed contract rate changes by payer, inflationary charge master changes, trends, or changes in demographics or technology


• Compare a diversified patient case mix with multiple plans against a single plan


• Analyze profitability by product lines, contract, physicians, and services


• Identify alternatives for severity-based contracts, case rates, sliding scales, stop losses, line-item exclusions, and multi-tiered per diems

Manage denials and successfully appeal denied claims to secure payment

• Track and monitor technical denials such as coordination of benefits requested, another payer is primary, invalid or missing subscriber ID, terminated coverage, and more


• Categorize and route denial types to the appropriate resource for resolution and appeal using a standardized, paperless process with all denial information in a single database


• Identify responsibility for cause of the initial denial, when appropriate

Monitor and plan for adherence with rules to proactively minimize denials

• Track and monitor patients with a process to follow the criteria to keep from not getting paid


• Avert clinical denials such as services not authorized, no pre-authorization obtained, services rendered are "out of network," no PCP referral obtained, and more


• Equip nurses with automated tools to perform utilization reviews, case management, discharge planning, risk and quality management