Revenue Cycle Management

Women's Health Connecticut provides Revenue Cycle Management services through our Central Billing Office, which currently files all claims for 237 providers including Ob Gyns, Urologists, Perinatologists, and Reproductive Endocrinologists.

Working closely with our Managed Care, Compliance and Risk Management, and Coding Teams, our dedicated, professional staff of over 50 employees assure that we meet current industry guidelines and regulations.

 We can provide the following services:

• Customer Service - We handle all the patient calls regarding balance after insurance, outstanding co-pays, patient deductibles and Medicare covered/non-covered services.
• Self-Pay Collections - We do all patient billing and follow up. We have an aggressive self-pay team that will exhaust all efforts before sending the bill to an outside collection agency. We work with the physician practice at the point of agency collection so that they are involved with the decision making to place their patient into collections.
• Insurance Collections - Claims are followed up in a timely manner. The percent of claims paid within 90 days of submission is over 93%, compared to MGMA averages of 81.
• Payment Posting - All payments are posted in the Central Billing Office including Electronic remittance.
• Claim Scrubbing - All claims are scrubbed prior to submission utilizing Correct Coding Initiative (CCI) and insurance specific edits.
• Payment Auditing - Payments are audited to ensure appropriate contracted reimbursements are received.
• Denials Management - Certified professional coders are on staff to review and appeal denied claims.
• Insurance Guidelines - Payor guidelines are maintained and provided to all customers.
• Training - Extensive internal and external training is provided and Web Ex sessions are also available for self-paced, self-scheduled training.
• Reporting - our data warehouse technologies allow us to create customized reports that supplement our robust reporting capabilities.  

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