Performance Solutions

Meeting providers where they are to take them to the next level

Too often, the day-to-day need to run an effective practice stands as a barrier to developing an innovative strategy for future success. Yet, developments in how organizations implement and optimize practice management and Revenue Cycle Management (RCM)—driven by a need to capitalize on new payment models—are creating transformative improvements for forward-thinking physician leaders.

When it comes to these practices, Continuum Health focuses on three key areas where we apply our proprietary process improvements to help practices capture every dollar they’re owed:

  1. Maximizing front-end process:

    Our credentialing and provider management, insurance registration and verification, and coding audit experts play a vital role in ensuring that claims meet payer requirements before they are submitted. We also ensure that you’re using your technology to its fullest capacity to automate as many processes as possible and prevent errors.

  2. Enhancing denial management:

    By combining human intelligence with a forensic approach, we identify payment trends and implement real time adjustments to minimize preventable denials and make the most of every claim. We work closely with payers on your behalf, making sure they adhere to contract terms and deliver every last dollar you’re owed.

  3. Strengthening the payer-provider relationship:

    Despite the struggles and frustrations that come with managing payer relationships, the reality is that the people on the payer end are playing on the same team as you and your staff. Continuum improves the lines of communication and understanding between payers and providers to help providers get paid faster and to the full value of their contracts.

Continuum Health’s Performance Solutions team combines our deep understanding of payer rules, requirements, and contracts with a knowledge of provider needs. We act as act as both advisor and day-to-day partner, helping improve processes and leverage new technology to improve your organization’s bottomline.

RCM Excellence

Excellence in RCM is about more than operational software; it’s 
about efficient and effective processes powered by intelligent people with an experienced perspective. We support your margin so you can focus on your mission.

Services

  • Revenue Cycle Management
  • Credentialing and Provider Data Management
  • Insurance Registration & Verification (IRV)
  • Coding Audit and Compliance
  • Contract Management
  • Customer Solutions Center
  • Patient Call Center
  • Practice Performance Dashboards and Comprehensive Reporting

Benefits

  • Maximized front-end and clearinghouse edits
  • Minimized claims denial risks, supported by a library of 4,380 claims rules
  • Assurance that technology applications are operating at the top of their design
  • Payer support from seasoned provider advocates who help enhance the provider/payer relationship
  • Management of all payer contracts
  • Market and regulatory insights
  • Fee-for-service (FFS) to value-based care (VBC) transition support

Case Study:

By the Numbers: A Provider Compensation Increase Over 100%

Continuum assisted this Northern NJ non-surgical specialty practice in its transition to in-network status within the payer community, and helped improve productivity and patient workfl­ows.

This practice’s Net Income improved dramatically, and has continued to grow. In four years, compensation per provider increased over 100%.

This case study is intended to provide an example of how actual providers benefitted from Continuum’s services. Continuum does not claim that the outcome of this particular case study is a typical result, or that it is necessarily representative of all those who will use its services. Continuum expressly disclaims any representations or warranties in relation to this case study or the information presented on this document.