We believe every hospital has the right to get paid fairly for services rendered, and when appropriate, hospital entitlements should increase. You have the right to be paid for all reasonable costs associated with the services you provide. At a minimum, hospitals should get reimbursed for their services based on rates mutually agreed upon in their contracts with insurance companies. We understand the shift in hospital finance, and now there’s greater dependence on patients paying their bills. Today, more than ever, money is tight.

While it is the payer’s obligation to pay contracts properly and set up rates fairly, from our experience and for various reasons, at least 1%* (and in some in instances considerably more) are not, resulting in tens of millions of dollars in lost revenue. Our FIT Revenue Recovery service is designed to find this income, improve billing, and tighten your internal controls. We have recovered tens of millions of dollars with our proven, unique system.


WHY GET FIT?

Reason #1: We recover money from payers you may not even know you were entitled to receive.

We can help you take what’s rightfully yours, and you can do it with very little effort. Typically you may hire vendors to try to recover balances you are aware of, but just don’t have the resources to work. You may contract them to handle accounts you know were underpaid. But, we believe there is a whole population of Zero-Balance accounts, where additional money is owed, that you do not even know about. We find opportunities to re-submit these bills, for additional money you are entitled to contractually.

There are a number of reasons for these types of underpayments. We identify errors in payment due to incorrect contract management, incorrect reimbursement by the payer, incorrect billing. With constantly changing contracts, it must be hard to get it right every time. We’re only human, so it’s natural for these minor errors to occur. But, these “minor” errors lead to major losses in revenue- tens of millions of dollars! And, frequently, we find that many of the accounts we identify are not being worked by anyone, leaving this income behind.

You don’t know what you don’t know about. If you give us the data, we can leverage our Halcyon system, and have our analysts take a look. There’s no risk, no set-up costs. We believe so much in what we are doing, that we will work to recover money for your hospital on a contingency basis. We won’t charge you anything, until we recover money for you.


Reason #2: We know contracts are complex. With our expertise and technological approach, we can simplify the identification and the recovery so you get paid what you deserve.

You may be wondering how we can possibly do this. We know you have great people in your organization that work hard every day to manage the revenue cycle. So, our approach is totally unique. We offer you a service, unlike the any you currently have in place. We like to think of it as a “safety net” for your hospital.

Our experts leverage our powerful Halcyon Decision Support System to find income, improve profits, and tighten controls. First, we load up your data and your contracts into the FIT module of our Halcyon DSS. Each account is grouped, and gets “re-priced” to arrive at the highly accurate “FIT Price”. Then, FIT runs sophisticated “edits” and “exceptions” to compare the FIT Price with what the hospital billed/was paid. Material exceptions are identified via a worklist for our team to review.

Our experienced hospital contract/billing analysts review the system findings to determine whether or not an additional revenue recovery opportunity exists, and if the account should be re-billed. If so, we gather all necessary documentation to re-submit the bill for the account, and perform all follow-up straight through recovery. We loop this information back to you; we show you where and how we found the underpayment. This pays for itself tenfold, as you can use our findings to tighten your internal controls, and improve your overall revenue cycle operation. The bottom line, we want you to get what you are entitled to receive for every account, every time.


Reason#3: We’re not going to disrupt your operation. We’ll work independently while keeping you informed.

We realize you may be intrigued, but you’re probably overextended as it is. Who has the time to put another system in place, right?  Wrong! We create a virtual business office, behind the scenes. We do all of the edits and analysis. If we need anything else to bill an account, we come to your hospital and get it.

We note each account on your hospital’s system, so you know exactly what we are doing, and what the status of the account is. You’ll always know exactly what’s going on. We complete the whole process, start to finish, to bill and collect what is owed to you. And, what’s more, the money goes directly to your “Accounts Receivable”, and you pay our fees only after you’ve received payment.

If we find an issue that is open to interpretation, we do everything to ensure you receive what is intended under the terms of the contract. We pride ourselves in our ability to synthesize down the intent of the contract terms, and act as a strong advocate to recover revenue entitlements on your hospital’s behalf. We err on the side of conservative, but when it was just and necessary, we have challenged insurance companies, gathered data, prepared all of the information for our clients to state their case, and we have won.

No Risk

The FIT Program will pay for itself many times over with little investment of a hospital's time, money or manpower. With most institutions the necessary data to fully implement the FIT Program can be obtained within a matter of weeks.

Significant additional revenue, greater profit outcomes and tighter control over your managed care billing have never been this simple. To engage us for a FIT review of your hospital, please contact us at 1-888-HWCSOFT (1-888-492-7638) or email us at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .