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Published by Convergent Outsouring, Inc., 2019-03-19 11:25:28

Convergent Healthcare Corporate Fact Sheer

RCM Fact Sheet 2019

CORPORATE FACT SHEET

CRCM forms the healthcare division within Convergent.
With more than 500 employees, including a complement of
healthcare attorneys and clinical staff, CRCM is the leading
provider of Aged Problem Claims, Conversion Accounts,
Insurance Early-Out, Workers' Compensation, Motor Vehicle
Accident and Self-Pay Solutions. In addition to helping our clients
resolve their most complex reimbursement issues, CRCM’s legal
workshops, training and real-time interactive reporting enhances all
aspects of the revenue cycle.

Outsourcing – AR Management Services – Third Party Claims –

Early Out Programs - Collections

■ Specialized Programs/Clean-Ups Third Party Liability (WC&MVA)
■ Third Party Liability (WC and MVA)
■ System Conversion (Pre/Post Conversion – MOTOR VEHICLE ACCIDENT PROGRAMS:

Aged AR) CRCM begins managing motor vehicle accident
■ Problematic Government/Insurance Denials accounts immediately from the patient’s discharge,
evaluating all potential payers and aggressively pursuing all
and Denial Management Services payment sources, including the patient’s insurance policies,
■ Patient Portion - Self Pay/Early Out/Bad Debt the responsible party’s automobile insurance policy, and
alternative sources such as the patient’s health insurance carrier,
Specialized Programs/Clean-Ups Medicare, or Medicaid. When warranted, we protect the interests of
our clients through the timely filing of liens and procurement of
CRCM digs deeply into accounts that are not enforceable letters of protection from the patient’s attorneys. CRCM
being pursued effectively to find additional also employs a dedicated team of attorneys and Senior Claims
reimbursement due. We use attorneys to Specialists specializing in MVA cases; these experts can navigate the
provide intensive follow-up on all delayed entanglements of the legal system to help free your staff’s time and
accounts, and legally- oriented written appeals avoid lost revenue.
to secure reimbursement on denied accounts.
Our highly trained legal team of attorneys and WORKERS’ COMPENSATION PROGRAMS:
senior reimbursement specialists has the
healthcare exclusive expertise— and legal CRCM takes an aggressive approach to obtain faster and higher levels
clout—to resolve outstanding issues and of reimbursement for Workers’ Compensation claims. We apply
expedite maximum payment. A clean up or advanced technology to calculate anticipated reimbursement for claims
custom project can help to reduce accounts in states with complex fee schedules, allowing us to accurately identify
receivable and liquidate these claims quickly, and appeal underpaid claims. Our specialized, attorney-led teams use
thus increasing cash flow and freeing your staff technology, deep understanding of state-by-state Workers’
to focus on other areas. Compensation regulations, and rigorous follow-up to collect what is
legally due from every claim.
Conversion Programs

CRCM and its expert business partners are a highly specialized team designed to help our clients make a seamless transition to
their new patient accounting system. Our breadth of system conversion experience and specialized resources enable your
staff to learn a new system while staying laser focused on achieving leading practice accounts receivable metrics before and
after the transition.

13575 Heathcote Blvd., Suite 300 Gainesville, VA 20155 I www.ConvergentUSA.com/healthcare I (404) 849 - 5514

Problematic Insurance Denials & Denial Management Services

CRCM’s proven and successful approach is based on years of experience and continuing
education on the various, state specific guidelines governing the adjudication process for
Problematic Insurance Denials and Denial Management Services. For the past 30 years, CRCM
has operated and continues to build upon a department solely dedicated to disputed claims and
focusing on exceeding our client’s and standard industry expectations. CRCM maintains a very
low representative to claims ratio allowing representatives to focus on the various factors
involved and put in the necessary time to determine the best approach to resolve the claim
most efficiently while delivering the largest return to our client. Our specialized legal
department provides a level of scrutiny, assertiveness and professionalism that is unmatched in
the industry. In addition, CRCM continues to evolve along with the industry by forming best of
breed strategies and solutions by utilizing team members who have successfully handled many
areas of the revenue cycle, particularly to include designing, building and deploying a Disputed
Claims division through the use of cost effective technology.

Patient Portion (Self Pay and Bad Debt)

SELF PAY RECOVERIES PROGRAM:

CRCM’s “patient experience” philosophy is the cornerstone of our Self-Pay environment. Patient
education, listening skills, payment solutions and question resolution make our early out
program successful. We partner with our clients to understand all aspects of established credit
and collection policies and provide additional suggestions throughout the program to maximize
effectiveness.

CRCM’s Patient Accounts Representative training program focuses on customer service and
quality with the goal to achieve first call resolution. The Patient Contact Center goals also
contribute to the customer experience through service level attainment, reduction of
abandoned calls and low average speed to answer. In addition to the ability of our client
partners to remotely listen to live calls in our Patient Contact Center, the recent implementation
of our proprietary scorecard software enables management and our associates to monitor
individual performance as compared to client key performance indicators in real time. Our
scorecard software is an example of the leading edge technology and best of breed
technology/analytics platforms we utilize to differentiate ourselves from our competition. Our
statements are colored and adhere to Patient Friendly Billing guidelines and are proven to be
highly effective in combination with our proven patient follow-up strategies.

BAD DEBT RECOVERIES PROGRAM:

Bad debt services are provided by Convergent Healthcare Recoveries, Inc. (CHRI), an affiliate
company of Convergent Revenue Cycle Management, Inc.

Convergent Healthcare Recoveries uses specialized representatives, advanced healthcare
scoring models and powerful workflow technology designed to help our clients maximize
recoveries while maintaining the goodwill of the patient. Our experienced teams, driven by
HIPAA, FDCPA and TCPA regulations, pursue every possible reimbursement source. We use an
advanced healthcare scoring model to better identify charity care and increase efficiency,
predictive dialing to make collection cost-effective, and proprietary processes to maximize
reimbursement while remaining sensitive to your patients. CHRI provides flexibility when
working accounts based on segregation criteria that our clients may require.

13575 Heathcote Blvd., Suite 300 Gainesville, VA 20155 I www.ConvergentUSA.com/healthcare I (404) 849 - 5514


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