the third-party payer before they can be submitted for payment. They
also analyze incoming payments to ensure that the payment received
conforms to the contractual terms.
The second type of product is closely related to the first and is often
referred to as contract analysis tools. These tools are designed to assist
hospitals in analyzing their experience under the existing terms of the
contracts and offer financial analysis and modeling capabilities to
evaluate contract profitability when negotiating contract renewals.
The third type of product is patient liability estimating tools. These
tools are used to estimate patient out-of-pocket costs above and
beyond their insurance coverage at or before the point of service. With
healthcare costs increasing at several times the general rate of inflation
and health insurance premium costs rising accordingly, employers are
restructuring their health benefit programs to shift more liability to
their employees through higher copays and deductibles. At the same
time, the number of uninsured Americans is increasing and recently
surpassed 45 million, or about 15% of the general population. This
shift to higher patient liability has increased bad debt and led
healthcare service providers to seek methods to improve point-of-
service (POS) cash collections, where the probability of collection is
highest. Also, state and federal policy shifts are pressuring service
providers to be more "transparent" in their pricing and cost disclosure
practices. Compliance with these initiatives requires providers to
accurately estimate the cost of service and the respective liabilities of
patients and their insurance carriers prior to receiving service.
Accuro is one of the leading independent vendors of revenue cycle
management products in the areas of contract management, contract
analysis, and patient liability estimating. Accuro Contract Manager,
Accuro Contract Modeler, and Accuro CarePricer address these three
categories, respectively. Health Industry Insights interviewed Accuro
customers that had been actively using one or more of these products
for at least six months to gain insights into how the use of these
products helped the hospitals achieve quantifiable economic benefits
and related process improvements.
ACCURO PRODUCT OVERVIEW
Accuro Contract Manager and Accuro
Contract Modeler
Accuro Contract Manager assists business office staff in accurately
calculating and capturing all net revenue contractually owed. It
streamlines the third-party billing and collections process; reduces the
rate of claims denials and underpayments; facilitates claim
resubmission, if required; expedites the collection cycle; improves the
accuracy of accounts receivable; and assists in the management of
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'2008 Health Industry Insights, an IDC Company
