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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.
Make sure all contracts are cared for with the help of our team. Boncura helps educate and empower hospital and health system staff so that they can efficiently handle physician contracts. With strong account management in place, you can focus on managing and negotiating your hospital’s or health system’s contract with insurers.
If you’re running a busy practice, you don’t have time to spend researching the nuances of value-based contracts. Bring in Boncura to educate your team and help manage provider relations.
Contracts are key for ACOs, so negotiations matter. Partner with Boncura and know that you have advocates on your side. Our experienced team will educate your staff and help you secure the most competitive contracts.
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.
Boncura puts a team of data scientists and software in place so that your health system doesn’t have to. Focus on running your medical center with confidence that physician practices are operating smoothly.
Boncura gives physician groups access to resources they may not have the capital to secure themselves. You don’t have to cover the overhead costs of data scientists and software; we’ve got that covered.
Data is an essential component of a financially successful ACO. Meet all of your value-based care metrics and incentives to make sure your ACO meets its financial targets. We’ve got the details and data to get you there.
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.
Billing and collections work for employed and contracted physicians can take up valuable time for health and hospital system administrators. Let us streamline your operations so that you can focus on hospital services.
Our in-house expertise and time-tested processes allow physician groups to quickly and efficiently handle billing and collections without needing to train or hire staff. Partner with us and experience the difference.
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.
Managing a hospital or health system requires numerous resources — let Boncura be one of your most trusted team members. We can handle call center operations so that you don’t have to stress about staffing.
When call volumes get too high, we’re here to help. We offer ongoing call center management or can serve as an extension of your team during peak periods. From handling patient questions to billing and claims, our call center team can provide the support you need.
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.
Boncura can help you craft a care path for patients in value-based contracts and understand reporting needs along the way. Additionally, our in-depth insights showcase where gaps exist so that you can work toward improvement.
We’re here to help physician groups take advantage of population health incentives. We create treatment plans so that patients can better navigate the healthcare system and provide reporting services so that your group can identify areas for improvement.
Manage the population health metrics of patients by partnering with our team. Our case management and analytics services will help you identify areas for improvement and can ultimately impact your bottom line.
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.
Make sure your claims are entered swiftly and accurately with the help of our team. Boncura’s claims processing specialists catch every detail to avoid delays in processing and physician payment.
Our claims processing team has access to resources that benefit physician groups. Let Boncura manage your claims processing tasks with state-of-the-art software and a trusted group of experts.
Make sure your claims are processed efficiently and showcase your adherence to value-based contracts with the help of our team. Boncura’s in-house experts make sure that claims are paid and processed promptly.
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.
When you’re buried in day-to-day operations, it can be difficult to identify opportunities, mistakes, and risks. By bringing in a third-party expert like Boncura, you’ll be able to identify areas for improvement and make sure you’re operating within regulatory boundaries.
With government regulations changing at a swift pace, smart physician groups are bringing in outside experts to help them keep up. Partner with Boncura and operate with confidence in the face of complex policies and regulations.
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.
Boncura’s team of coding specialists knows the ins and outs of physician service coding — and are happy to handle it for you so that you can focus on hospital services.
Reduce errors, save time, and boost your bottom line with the help of our coders. With the right tools and resources to make sure coding is handled efficiently and accurately, we’re the administrative partner many physician groups need.
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.
Hospital and health system administrators need to focus on the big picture — which is why they benefit from having Boncura handle many of their day-to-day tasks. Our experts take care of physician credentialing and payer enrollment so that you don’t have to.
Staffing up or adding new contracts? Make sure your physician team is properly contracted and ready to participate. Boncura can get them verified.
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.
Don’t let eligibility work impact your hospital or health system’s efficiency. Boncura can contact a patient’s insurance and make sure they’re eligible for your services before they set foot in your facility.
We keep patient data up to date so that patients receive the care they need and physicians have reassurance that patients are eligible for recommended treatments. Partner with Boncura to resolve eligibility issues before they impact your bottom line.
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.
Hiring and managing the right staff for physician practices is important — but many hospitals and health systems simply don’t have the HR resources to do so. Boncura provides the assistance you need to keep physician practices staffed and running smoothly.
Many physician groups need HR services, but don’t have the capacity to hire someone full-time. With Boncura on your side, you can streamline HR tasks like business and payroll operations — without putting a major dent in your schedule or budget.
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.
Instead of investing your own time and resources into a new IT system, let our team take the lead. We provide the software and expertise hospitals and health systems need to manage referrals and reporting for physician practices, saving you hours of training time and overhead.
The best software is out of many physician groups’ reach — unless they work with a partner who has access to it. Partner with Boncura to gain access to the systems you need for referrals and reporting.
Gain access to the best industry technology — and some of the best industry IT experts — without needed to staff up or spend big. Boncura has access to IT infrastructure that can help you quickly manage contracts and referrals.
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.
Achieve the Triple Aim with the help of our team. We’ll review outcome data and show you ways to improve so that you can boost your bottom line.
With Boncura on your side, you’ll have the expertise and resources needed to collect, report, and analyze value-based care contract measures, as well as make progress toward achieving the Triple Aim.
Boncura’s quality management process puts actionable data in front of your leadership team so that you can improve quality measures, data capture, and reporting — ultimately helping you achieve better reimbursements and make progress toward the Triple Aim.
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.
Make sure all risk associated with your beneficiaries is accounted for with the help of our team. Boncura helps track claims payments, care coordination, and case management to reduce the number of unplanned readmissions, manage expected cost of care, and costs for care following a stay at your facility.
Boncura’s risk adjustment services free your team up to focus on forecasting accurate premium projections and meeting CMS benchmarks through robust, in-depth Medicare scoring, metrics, and data analysis. Let our experts help guide your biggest decisions and identify areas for maximizing incentives.
Beneficiary risk scores can be a challenge when managing aging populations. Our experienced team will ensure your organization receives the maximum incentives for your contracts, identifying savings based on claims payments, care coordination and case management for 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 empowers hospitals and health systems with information on out-of-network referrals. Let our team step in and quickly identify where leaks are happening.
Our objective, evidence-based approach to utilization management allows physician groups to quickly access referral information and make smart decisions for the future. Avoid guesswork with the help of our experts.
Boncura’s data-based utilization management services allow you to provide reports that are backed by objective, detailed information on referrals and leaks. Let our team uncover the insights you need.