Consulting and Outsourced Services
A full range of account billing and follow-up services customized for your organization.
Denials & Appeals
Our vastly improved methods lead to more audit reversals and less denials for our clients.
Best available solution in Telehealth, EHR and Data analytics – with easy integration with your systems.
Executive Search & Staffing
With over 30 years of experience on the business side of healthcare, we already know the best person for your team.
Cain is redefining healthcare to be faster with more accurate claims submission, which allows for greater flexibility in managing the financial side of patient care – from registration to final payment.
We believe healthcare works better as a relationship. That’s why we collaborate closely with our care partners – networks of doctors, clinics, and hospitals to put the focus back on your bottom line. Together, we work hand-in-hand to bring patients the best possible care at the best possible price – we are redefining healthcare.
Clinical Documentation Improvement
CAIN CDI services are a concurrent process under which clients have access to the CAIN network of clinical documentation specialists. Clients receive a full range of clinical documentation services. These include consulting, assessments, project management, educational programs and the full outsourcing of the CDI function for all or select payers.
Through CAIN’s secure network, clients can outsource all their coding needs, whether for hospital inpatient, outpatient or professional. We offer a full range of consulting, project management, auditing and full outsource services.
Patient Account Billing
Services can be provided utilizing either the client’s systems or CAIN proprietary systems. Services range from AR reduction projects to early out programs to a full outsource of the billing function.
Patient Account Follow-Up
CAIN can work in unison with a client’s in-house patient account billing staff or can provide an independent range of services that are customized to meet the client’s needs. This can include everything from accounts receivable clean-up projects to early out programs to a full outsource of all patient account follow-up services, including self-pay.
If CAIN is providing account follow-up services, these services are included as a matter of definition. If CAIN is not providing routine follow-up services, denial management services are customized to specific account age groups and/or payer groups. CAIN’s follow-up staff works closely with our clinical networks to provide the information necessary to resolve denied accounts.
Third Party Audit Management
This service is the healthcare industry’s answer to the threat of government and third party payer claims audits. CAIN’s staff of utilization review nurses, certified CDI and coding specialists and Physicians representing over 75 specialties, combined with our proprietary process management system, assures that all steps are addressed in a timely and accurate fashion. Appeals are aggressively pursued by our clinical staff and targeted education programs are developed and presented to minimize future audit exposure.
Physician Advisory Services
CAIN utilizes its broad clinical networks to assure clients achieve their goals of managing clinical care while maintaining regulatory compliance and sound financial performance.
Telemedicine & Remote Care
CAIN has a fully integrated IT solution including Telemedicine, Electronic Health Record, Patient Portal, and Remote Patient Monitoring that facilitates monitoring of patient’s vitals and also supports Chronic Care Management (CCM) and Transitional Care Management (TCM).
Our innovative approach to Clinical Transcription includes voice recognition, elimination of Physician self-edit, and a secure web portal to facilitate transmission of completed documentation to client EMR.
CAIN, working with our highly skilled network of Revenue Cycle professionals utilizing state of the art proprietary technology, finds third Party insurance coverage for self-pay, bad debt, Medicaid and Charity Care accounts. This Program begins with a two-year lookback of accounts in these categories to determine the size of the opportunity but can also be implemented as an ongoing process. All fees are based on a mutually agreed contingent percentage of new revenue generated from the program.
Patient Friendly Self-Pay Financing
CAIN offers a true NON-RECOURSE financing program for all patient responsibility accounts receivable. The service is available to all types of Healthcare Providers and is customized to meet both our clients’ and their patients’ needs. State of the art technology and quick and simple enrollment make this program a great alternative for the resolution of self-pay account balances.
Third Party Payer Accounts Receivable Funding
CAIN, working with its network of financial partners, offers a broad range of alternative financing products to the healthcare industry. Primary in these offerings is the purchase and/or financing of third party payer accounts receivable. All types of third party payer accounts receivable are considered. This program can be integrated with CAIN’s patient account billing and patient account follow-up and collection services to optimize its efficiency and effectiveness.
Alternative Finance Programs
CAIN can provide customized alternative finance programs to facilitate asset leasing or purchase. We also offer asset sale/lease-back programs to facilitate capital formation.
Executive Search and Direct Placement
CAIN offers customized Executive Search/Direct Placement for the business side of healthcare. We fill positions for Management, VPs, and C-level executives and Partners in: Finance, Operations, Revenue Cycle/HIM, CDI, Technology, Human Resources, Administration and Consulting/Outsourcing.
Interim and Project Staffing
CAIN can expand the scope and depth of your capabilities with our Interim Solutions and function as either an engine running behind the scenes, or if you prefer, be fully visible to your clients. Whether you seek individual contributors, project teams, managers, or an interim executive for short or long-term engagement, we offer immediate solutions on a remote, onsite or travel basis.
Leading the Industry for Over 20 Years
CAIN offers a wide range of revenue cycle management products and services for hospitals, physicians, and healthcare systems. Our services help organizations achieve their financial goals and make more informed decisions.
William Scott Cain
Scott is a highly sought after expert. He has owned multiple successful businesses, managed hundreds of millions of dollars for insurance companies, has been a Medicare Regulator, and helped hundreds of providers recoup revenue since forming CAIN Health. Few in our industry possess his depth of knowledge, connections and expertise.
Justin Oliver Cain
Justin is a brilliant software engineer with many years of experience in the IT side of the healthcare industry. He has integrated multiple disparate systems, designed innovative automation solutions and provided engineering expertise for massive enterprise systems. He is also an expert in secure e-commerce systems generating over $1M in daily revenue. Justin is a true leader and innovator with a passion for the business of healthcare.
We are located in sunny Phoenix, Arizona but frequently travel to the east and west coasts.
4450 N 12th St #210,
Phoenix, AZ 85014