Our Services

HFRI is altering the hospital AR landscape by delivering unparalleled speed, scalability and accuracy to the insurance AR management process. Through our proprietary, intelligent automation and powerful process engineering, we’re able to resolve all claims, regardless of size or age quickly, due to our system’s automated decision making and notation that guides the user step by step. That means you’re able to recover collections from insurance claims that otherwise would have been written off.

Our AR management services are easily integrated into your hospital’s existing workflow to seamlessly function as an extension to your existing billing office. HFRI specialists collaborate with your team not only to assist with your denial management initiatives but to identify root causes that will help prevent denials from occurring in the first place.

HFRI has experience handling all situations and all payors and can take on any special AR projects you have in mind. Our special projects have covered clinical denials (including prior authorization and medical necessity), coordination of benefits, and patient denials, high- and low-balance account resolution, aged problematic accounts, and worker’s compensation/personal injury. We have expertise in all facility types and specialties—from acute care to critical access, from rural medical practices to large urban multi-hospital systems, and from general ER to specialized children’s facilities—plus knowledge of the intricacies and differences of each.

Accounts Receivable Solutions

• Primary AR recovery and resolution: We pursue aging, small-balance claims identified by your staff as problematic. If a claim has previously been worked internally, referring it to HFRI’s dedicated, specialized teams can help ensure quicker cash conversion and a reduction of bad debt reserves.
• Pre write-off AR recovery and resolution: In addition to primary AR recovery and management services, HFRI also offers pre write-off (often known as secondary) insurance AR recovery to help you collect highly-aged claims and minimize write-offs.
• Legacy system conversions: Transitioning to a new system can slow down the claims process and create problems for hospital personnel who must work between two billing platforms. HFRI can provide interim solutions to help you accelerate pre-conversion cash and assist with post-conversion AR resolution.
• AR recovery projects: HFRI is available to assist you on a temporary project basis to address AR backlogs that can’t be worked by your existing staff.
• Revenue Cycle Consulting: improves reimbursement, reduce denials, and decrease audits.

Step up your Revenue Cycle

In addition to our Accounts Receivable Solutions, we offer a range of revenue cycle services including pricing analysis and solutions. These solutions are individually tailored to achieve the results necessary to meet both your immediate and long-term strategic requirements.

Pricing Transparency

• Price Transparency Tool: helps enable consumers and patients to calculate their share of cost for key services the facility decides to make available via their website.
• Charge Quote: provides timely and accurate patient estimates for self-pay, Medicare, and commercial payers.

Revenue Cycle Services

• PARA Data Editor: a web-based single source and cloud computing solution to avoid loss of reimbursement and improve your revenue cycle process.
• PARA Data Maintenance: implementation of annual pricing updates for CPT®/HCPCS codes.
• Purchase Item Master Review: brings together the coding and financial analytic components of our services to create a process that maintains the purchase item master (PIM) and Charge Description Master (CDM) systems simultaneously.
• PARA Revenue Integrity Program: audits the hospital revenue cycle to ensure appropriate charges are created, captured, coded, and priced correctly.
• Charge Master Review page: ensure your hospital’s Charge Master is up-to-date and compliant by identifying and correcting errors, compliance issues and missing charges.
• Contract Analysis: assesses your hospital’s contracts to ensure effectiveness and better reimbursement

Pricing Analysis

• Market-based Pricing: identifies line items in the charge master which have negative patient satisfaction due to high prices, identify gross margin improvement opportunities due to low prices and help establish a rational pricing methodology by setting prices based on fee schedule, APC, cost, or competitive market pricing data.
• Supply Pricing Analysis: assists with standardizing supply pricing across all departments and services by providing a ration, cost-based supply markup.
• Pharmacy Pricing Analysis: creates a rational, cost-based pharmacy markup using the cost basis and charge categories as determined by the client to meet required guidelines.
• Physician Practice Pricing Analysis: optimize practice net revenue by ensuring individual charges are priced at market rates and cover all contracted fee schedules.