Provider services and solutions

Financial performance: Virtual Business Office

The challenge

Rapidly aging accounts receivable (A/Rs) are a continual drain on hospitals' time and finances. Towering volumes of past-due claims eat up staff time and stimulate additional hires, heightening overhead and lowering ROI.

Problems within the front and middle wheels of the revenue process management cycle, such as pre-registration errors, failure to obtain proper authorization, and incorrect or miscommunicated coding, can produce incorrect claims early on. If these mistakes are not caught in time, claims arrive in billing departments destined to be denied, and the older they become, the less likely providers are to collect on them. Once denials are received, prioritizing and managing them becomes a major task that can require a massive administrative framework.

How we can help you

PricewaterhouseCoopers' Virtual Business Office (VBO) is a virtual extension of your brick-and-mortar business office. Our VBO connects directly to your patient accounting system through a virtual private network (VPN) to resolve your accounts receivable at their source. PwC creates a detailed procedural document and a customized playbook that mirror your hospital’s unique policies and procedures for handling A/Rs, creating a true virtual environment. And PwC's VBO leaves a clear trail of the notes and actions performed so your system remains the system of record for compliance purposes.

We can help you:

• Remediate third-party aged accounts receivable
• Make your existing workforce more efficient to increase cash flow to achieve month-end or year-end goals
• Perform insurance verification or pre-registration services
• Manage increases in claims volume, special projects, or A/R campaigns
• Answer customer service lines and perform other customer service related duties
• Maintain work queues for employees out due to sick leave, vacation, attrition, holidays, turnover, or FMLA
• Gain insight into the root of your A/R issues and holdups

PwC's engagement teams typically help clients collect anywhere from 20 percent to 40 percent of the collections referred to us.