Revecore helps hospitals outsource complex claims for faster and increased recovery

How do you help healthcare organizations navigate the biggest challenges in healthcare?

Complex Claims (motor vehicle, workers’ comp and Veterans Affairs) represent a very small volume, are extremely manual and are highly unique to all other claims. Revecore gives hospitals the opportunity to outsource these claims to a firm with unparalleled technology and 22+ years of experience, focusing exclusively on complex claims. The result: Hospitals are able to focus on their core revenue cycle while yielding faster, increased recovery on their complex claims portfolio. 

Our standardized approach brings compliant best practices to hospitals in almost every state, maintains legal awareness and processes to updated legislation and case law, streamlines insurance identification and billing and follow-up, decreases days to pay and increases revenue. Healthcare revenue cycle teams get the manpower they need for these niche claims thanks to our automation, near real-time insurance identification, workflow processes, client-, state- and insurance-embedded customizable rules and clearinghouse billing to the property and casualty market, as well as working alongside the most tenured team of specialists and attorneys in the industry. 

Case in point, our clients experience an ROI of 403% by working with Revecore.

What advice would you offer to healthcare leaders when choosing among vendors?

Revenue cycle executives should work with partners who have objective feedback (HFMA Peer Review, Best in KLAS), quantifiable case studies with numerous clients who are willing to discuss  their satisfaction, sufficient tenure in the industry, a substantial and recognizable national client base and superior technology. Healthcare leaders should be shown their vendors’ technology to let them see how it works and how it is unique versus just letting vendors talk about what their technology offers. This technology should be able to manage a large volume of claims with relatively short notice, include workload balancing, be customizable and deliver quick recoveries. Ideal vendors should have extensive legal expertise with a deep bench of in-house lawyers and an experienced team of professionals who have worked exclusively in this niche with minimal staff turnover. Leaders should expect detailed but not overly broad reporting, including placements and results with trending. Healthcare executives should choose a vendor that focuses their business on these specific claims. Firms with expansive offerings yield less focus, minimal investment and diluted results.

What is some advice you can give providers for a successful implementation of a new product or service?

Beyond an explicitly defined implementation process, providers should be receptive to the vendor’s suggested best practices and rely on its expertise. Vendors should have robust experience working in the client’s host billing system with best practices built around their specific system. As all services need modification at some point, clients should understand in detail how the vendor approaches and documents change management. 

Quick Facts

• 8 years on the Short List.
• 100% of peer reviewers agree or strongly agree they would recommend the service to colleagues.

About Revecore

Revecore is a leading provider of Underpayment Recovery; Denials Recovery & Prevention; Transfer DRG and Complex Claims Reimbursement. Serving 1200+ hospitals across the country, we offer health systems over two decades of unrivaled technology and expert insight into the most challenging areas of revenue cycle to ensure they are appropriately reimbursed for the care they provide.

To learn more about HFMA’s Peer Review program, visit hfma.org/peerreview