Services

Boncura provides a suite of services that allow hospitals and health systems, physician groups, independent practice associations, and accountable care organizations to operate smoothly. From compliance and reporting to billing and payroll, our team works with clients to make sure their back-end office operations are functioning efficiently — ultimately reducing unnecessary expenses and allowing providers to focus on quality care for patients. Whether you need assistance with one specific administrative service or you are seeking a full-time partner in handling your risk-based contracts, Boncura can help.

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Account Management

Keeping up with ongoing changes in policies and plans of multiple providers — as well as continually negotiating for your organization's benefit in light of these changes — can drain a healthcare organization's time and resources. Let Boncura work with providers and your team to make sure your business is best positioned to benefit from every plan, and stays ahead of changes. We'll also make sure to educate your staff and office managers so that plans function smoothly from start to finish.

Analytics and Reporting

The success of Boncura and our clients is largely driven by data transparency and analytics. Boncura’s skilled team of business intelligence developers and data scientists deliver actionable insights for our clients related to utilization, cost, quality, risk, network leakage, and transitions of care. Our customized Boncura Compass dashboard features content and metrics relevant to a client's specific needs. For example, a Boncura Compass dashboard could include up-to-date data on quality incentives, generics utilization, and accounts receivable trends.

Billing and Collections

Reduce the amount of time spent managing receivables, claims, and copays with Boncura’s billing and collections service. Our team helps clients submit error-free claims, handle patient billing, and work with insurers to accelerate the payment process and reduce unnecessary delays and costs. Enjoy access to billing and collections data so that you can quickly view information on topics like gross charges, pending accounts receivables, reimbursement levels, and net collections.

Call Center

The Boncura customer service team fields thousands of calls per week from members and providers. Professional, friendly, and empowered with the information and tools they need to fully resolve issues, Boncura customer service staff members deliver high-quality service in a timely and satisfactory manner. They work closely with participating providers to help with education and outreach, and also track key customer service metrics like abandonment rate and average speed to answer.

Case Management

Boncura works with clients in value-based contracts to offer reporting and case management services focused on improving a patient's long-term care and wellbeing. Case managers collaborate with providers and patients to assess, plan, facilitate, coordinate, and evaluate care services — overcoming gaps and fragmentation in the healthcare system and providing patients the support they need to continue on a path toward improved health. They help develop cost-conscious strategies to manage a patient's comprehensive and holistic health for the best outcomes and quality of life, and submit detailed reports to track progress. Boncura’s case management team helps improve population management through individualized support.

Claims Processings and Adjudication

Boncura continually surpasses the claims handling standards set by insurers and handles millions of claims for our clients. We thoroughly review claims to ensure accuracy — both before and after printing checks. Boncura handles claims processing and adjudication using the Tapestry Epic module, and we accept both physician and institutional claims electronically.

Compliance

Stay abreast with the latest changes in regulations and policies with the assistance of Boncura’s compliance team. It's our job to dig through the details of HIPAA and ACA requirements so that our clients don't have to. We'll identify compliance risks on a regular basis and recommend steps clients can take to resolve compliance issues in a reasonable and timely manner.

Coding

Whether you need long-term coding support or assistance overcoming a temporary backlog, Boncura’s coding specialists can help you reduce lag days, improve claims submission, and increase administrative efficiency through thorough and detailed coding. Our credentialed coders understand how to best use electronic medical records data to review for documentation and adherence to standard coding guidelines. Our risk-adjusted coders are familiar with the nuances of accurate diagnosis coding based on provider documentation, allowing them to optimize hierarchical condition categories (HCC) capture and submission.

Credentialing

The Boncura credentialing team is fully delegated by major payers and can assist in the initial credentialing and re-credentialing process. We support providers and facilitate interactions between physicians, hospitals, surgery centers, and payers. Our team collects and verifies professional and academic qualifications; facilitates the application process; and helps handle provider enrollment with selected health insurance payers. All credentialing services are performed in accordance with National Committee for Quality Assurance standards.

Eligibility Administration/Member Attribution

A patient's visit should be about receiving care — not wrestling over insurance details. Boncura’s eligibility administration team works closely with clients and our customer service team to make sure members' coverage details are available and up to date, and that patients meet eligibility requirements for recommended treatments. We proactively handle membership data for reporting purposes, keeping records up to date with the latest information in order to identify any issues and remain compliant with industry standards.

Human Resources and Payroll

Reduce overhead costs and enjoy the efficiency of automated, accurate HR and payroll services with the help of Boncura. Our team's industry experience and modern resources allows us to handle HR and payroll processes faster than many providers — simply because we have staff who are entirely dedicated to streamlining these administrative duties and providing the best customer experience possible. Our customized HR and payroll services will allow you to manage staff in a manner that's efficient for your organization and accessible to employees.

Information Technology

The Boncura team has expert knowledge of Epic's electronic medical record software. We utilize all of Epic's features to manage referrals, patient communication, and even population health reporting. By using Boncura’s IT team and systems, clients can seamlessly manage revenue cycles, managed care, and more. Our IT platform includes a number of Epic applications, enterprise business applications, hardware infrastructure, and network and telecom systems. We can also work with your team to improve the security of your IT systems.

Quality Management

Boncura’s quality program is designed to improve care for individuals, improve health for populations, and lower growth in expenditures — all of which are key components of achieving the Triple Aim in the changing healthcare market. As part of our quality management, we help clients identify standards of care using evidence-based medicine; collect, report, and analyze outcome data; comply with health plans and regulatory standards; collaborate with health plans, medical leadership, and providers; and continuously assess performance to improve care delivery programs. Our quality management services go beyond simple assessments and reporting — our team sits down with partners in person to make recommendations and present guidelines for improvement.

Risk Adjustment Services

Ensuring that your organization is reimbursed for all aspects of care is vital to every provider’s bottom line. Taking on enrollees with higher levels of risk should not mean lower Medicare scores. Risk-adjustment data collection can be challenging, but with Boncura working with insurers and your team to assist with tasks like claims payments, care coordination, and case management, including Medicare scoring, metrics, and data collection, your business will receive the best possible outcomes and incentives for your level of risk.

Utilization Management

Boncura's utilization management program is designed to ensure high-quality, yet cost-efficient, patient care. Our team works closely with health plans and network providers to offer services such as discharge planning; concurrent review of inpatient cases that require pre-certification or have exceeded expected stay length; review and determination of medical necessity and appropriateness of inpatient services and sites; and retrospective review of out-of-network referrals. Boncura utilizes nationally recognized review criteria in the utilization management decision-making process. The criteria are objective, evidence-based, and compatible with established principles of health care delivery.

Boncura helps provider organizations manage risk.

Learn how Boncura helped one physician group succeed.

Download The Case Study