American Healthcare Outsourcing Alternatives LLC (AHOA)

AHOA is specialized provider of call center services and back office support services. Our partner's in this venture are Besler Consulting, a highly respected healthcare consulting organization that has been servicing the revenue cycle needs of healthcare providers for over 23 years and Expetitive, a provider of interim revenue cycle staffing and recruiting . This affiliation allows us to deliver a broader range of services consistent with our goal of earning clients by delivering revenue enhancements; achieving operational efficiencies and assisting providers in maintaining their compliance goals. Besler’s focus on developing value based relationships is consistent with AHOA's own corporate vision. AHOA offers providers a comprehensive range of recievables management solutions to assist in the management of their revenue cycle needs. Some of these services are:

Our Self Pay collection program is geared towards successfully managing this challenging receivables class. By utilizing our technology and skilled personnel, your facility can maximize reimbursement from this portfolio segment. Our high level of expertise and technological sophistication allows us to capture more payments, ensure compliance and protect your interests. For example, in our environment, all patient calls are recorded giving you a permanent record of each conversation. We also support our clients by providing live Associate monitoring. For your convenience, we can perform our services in your name or ours. Call us for more information on how you can combat the growing impact of self-pay delinquencies and at the same time free your staff to focus on other key functions.

Our ED Revenue Enhancement program is a unique program designed to help hospitals improve revenue realization derived from ED Visits. Recently hospitals have been placing a lot of emphasis on improving revenue flows and reducing days ARO by capturing payments at point of access. However for this strategy to succeed providers must gather accurate patient information. However, information acquisition at certain points of access such as the ED can be challenging. In fact, most hospitals experience a significant degree of delinquency and bad debt write-off associated with their ED operations due to incomplete information about the patient or the event that prompted them to visit the ED. Our unique solution was created to address these challenges. We contact ED patients/guarantors within 72 hours of their visit. We ascertain the patient’s level of satisfaction with the visit, remind the patient to follow their discharge instructions and verify their address and telephone number. We also validate their insurance information and obtain any additional insurance information and attempt to uncover any liability information, i.e. workers comp, no-fault, personal injury liability. If the patient has an outstanding co-pay balance we offer to assist the patient by accepting his/her payment via check or credit card right then over the phone. We also assist patients by warm transferring them to the appropriate hospital staff member if they express a desire to be screened for financial aid such as Medicaid or Charity Care.

Our Denial Management program is dedicated to help your organization resolve this troublesome and time consuming process. We can handle all payor denials, including those for lack of pre-certification, invalid coding or delayed payment of claims. We will also review for correct payor reimbursement based on your contractual specifications.  Our system is able to set up a custom database that will categorize and order your denials. This capability provides comprehensive reporting which contributes to a stronger revenue cycle process.

Our Bad Debt Collection service is designed to assist providers deal with rapidly growing bad debt account portfolios. In part, this is due to the current state of the economy, but it also reflects the fact that deductibles patients are responsible for have grown exponentially and that employers continue to shift more of the burden of healthcare costs onto their employees, your patients. In the past, patients would make a minimum co-payment and insurance would cover the rest of the cost of the service. Now patients can find themselves responsible as much as $5,000 of the balance before any insurance reimbursement begins. It is clear that this trend will continue grow and that providers will need to focus on this financial class to maintain overall fiscal health. Bad debt accounts are one of our core competencies. AHOA has the resources to contact your patient/guarantor day or evening. We employ sophisticated locate data bases to make sure your patient is contacted and your bill is paid.

Our Payment Plan Monitoring program actively and professionally follows up with patients who have established payment arrangements. We can customize this process to dove tail with your current billing system or establish it as an independent process. In both cases AHOA will track the patient obligation to pay the provider of service by producing an auto-draft each month and/or generating reminder calls for current or pending payments.    

Our Coordination of Suppliers Service can assist providers' who use multiple outsourcing firms to service different components of their self-pay financial class. These may include collection firms, insurance follow-up providers and eligibility companies.  Often, there is little coordination between the various vendors. This, in combination with inadequate staffing budgets and dated technology leads to poor aggregate performance and the deterioration in the liquidity of their self-pay receivables. AHOA will provide solutions to facilitate movement of accounts to and from the appropriate outsourcing partner and develop measurement tools and dashboard analytics to maximize recovery and reduce bad debt.

Process Analysis-AHOA offers no cost in-house assessments including reviews of early stage policies and procedures relating to patient balances. Our analytics focus on identifying recovery opportunities and developing strategies to reduce days ARO while increasing patient satisfaction. AHOA's detailed evaluation will review all provider policies against industry and regulatory standards. Then, utilizing proprietary metrics and KPI's developed through extensive industry experience, we design specific approaches to effectively capture every available self pay dollar. AHOA will then offer a carefully structured set of standard operating procedures, designed around specific metric principles. Interfaces can also be provided to access the most effective technologies which can then assist in the implementation of the proposed process based solutions.

Our Patient Contact and Satisfaction Surveys are available to providers to determine patient satisfaction. AHOA works with providers to draft specific surveys and then conducts those surveys and generate custom reports of the results.