Your Problems and Our Solutions
Have a look at common problems in the Healthcare industry & our solutions to understand more.
Solution: What used to be more of an issue with government payers is now a growing concern across all payers. As the problem gets worse, solutions are becoming harder to find. Our programs in Patient Status Management, Clinical Documentation Improvement and Coding provide the opportunity to evaluate current or potential problem areas and implement corrective action.
Solution: CAIN’s 3rd Party Payer Audit Management program includes a proprietary process management system allows you to track all aspects of the audit process. Our extensive clinical networks allow our Denial Management program to aggressively pursue appeals on any type of denial. Data is collected to facilitate targeted education for corrective action to minimize future denials.
Solution: CAIN has a network of over 100 Utilization nurses and 250 physicians representing over 75 specialties that can customize a program specific to your needs. We have the resources and expertise to address any issue that may arise.
Solution: CAIN offers a proven Readmission Management program that will bring patient readmissions under control. Our staff of RN Health Coaches contacts your patients as soon as they leave the hospital. They follow up with them for the agreed upon amount of time to assure they understand and follow prescribed protocols. Nurses are located in our offices and are available on a 24/7 basis to assist your patients. Our RN Coaches will interact with other care providers as needed share information and make sure follow on care is being provided in the appropriate setting.
Solution: CAIN’s experienced billing and follow-up staff can help. Whether it’s an early out program or cleanup projects, we can provide the assistance you need. We cover all payers, including self-pay. When this service is integrated with our various clinical offerings, it can be very effective in resolving your accounts receivable challenges.
Solution: CAIN Offers a Patient Responsibility Funding Program that is managing this situation effectively. The program offers funding from $25,000 to $150,000 for patients with payments to you on a NO RECOURSE basis. For those patients with a FICO score of less than 540 or don’t qualify for other reasons, we offer monthly ACH based payment programs with terms consistent with your payment plan parameters.