Critical Care Billing, Coding, & Management Solutions

Emergency and Hospital Medicine groups face ambiguity around patient volume and reimbursement. Partner with Ventra Health to help your organization navigate these unprecedented times.

“I would recommend Ventra Health to any group that is seeking the best in a billing partner. I use the word “partner” because you will not just be getting a company who processes your claims, but as I have found, a partner who will truly help your company maximize your earning potential and at the same time be completely compliant with all the latest legal and documentation “hoops” that our government and the insurance industry will throw at you.”

CFO of an Independent Emergency Medicine Group

Emergency Medicine Faces Challenges and Opportunities

Emergency Medicine providers can overcome uncertainty. Ventra Health leads the way in showing practices how to optimize revenue cycle management, drive revenue capture, and improve the bottom line. You’ll learn how to prepare for shifts in balance billing, reimbursement, and the continued growth of the uninsured. Partnering with Ventra Health will ensure you have the best vantage point from which to take advantage of Emergency Medicine’s new and emerging revenue opportunities. 

The DuvaSawko & Gottlieb Legacy

Ventra Health’s strategic merger of DuvaSawko and Gottlieb in April 2021 signals a new era in revenue cycle, coding and documentation management for Urgent Care, Emergency, Hospital, and Observation Medicine. 

Both companies have a history of delivering end-to-end revenue cycle management and practice optimization solutions to hospital and independent physician groups. Throughout the years, their mission has never wavered: Help physicians navigate healthcare with technology-enabled solutions that increase net revenues and boost compensation. 

Now you can benefit from decades of knowledge, skill, experience, and credibility. Partnering with Ventra Health delivers the best of DuvaSawko and Gottlieb’s legacy of excellence in Emergency Medicine RCM. 

Revenue Cycle Management Solutions

Let Ventra Health manage the financial health of your practice –from managed care and clinician education to business intelligence and coding and documentation

Based on our experience supporting thousands of providers and managing the revenue cycle for millions of RCM cases annually, Ventra Health delivers the best in revenue cycle management. Here are just a few of the ways you will benefit from Ventra Health's RCM solutions:

Revenue Cycle

Turn to Ventra Health to manage revenue cycle--from billing and coding to accounts receivable and denial management. Ventra Health’s workflows, processes, and practices for charting and coding to reduce denials. 

Data-Driven Reports 

Count on Ventra Health to pinpoint the latest trends, implications, and strategies for physicians and payers.

MD Education and Training 

Depend on Ventra Health for timely, personalized clinician training on the latest trends, technologies, and tools in Emergency and Hospital Medicine, including coding and documentation. 

Dispute Resolution

Take advantage of Ventra Health’s easy-to use process for submitting requests for dispute resolution and arbitration. Benefit from a faster, more flexible, and less costly alternative to litigation. 

Documentation and Coding

Ventra Health helps you analyze, translate, and document patient/physician encounters. The result: You steer clear of payer audits and sustain compliance with regulations. 

Ventra Health’s branded Clinical Documentation Integrity Program offers your practice these benefits:

  • Partner with Ventra Health for a disciplined process of clinical documentation assessment, implementation, and maintenance. 
  • Access the best, most appropriate mix of tools, including--
  • Documentation shadowing, feedback, and coaching 
  • Group documentation education 
  • Billing and coding audit reports 
  • Documentation score cards 
  • Documentation trend analyses  
  • Documentation summary reports
  • Create electronic health records (EHRs) that ensure care quality and safety.
  • Maximize practice profitability. 
  • Guide clinicians through clinical documentation monitoring. 
  • Prepare providers for specialty and location audits. 

Revenue Cycle Management

Ventra Health evaluates your practice, patients, specialty, and industry before taking a deep dive into RCM, coding, compliance, MIPS reporting, physician education, managed care, and strategy.  

Practice Strategy

Ventra Health zeroes in on where you’re at and where you could be via payer strategy development, optimized processes, measurable compensation plans, patient experience re-design, compliance guidelines, and practice leadership.

Coding and Documentation

Ventra Health uncovers the difference between facility and professional coding by taking a closer look at ED procedures and E/M visit level coding. 

Revenue Analysis

Ventra Health accelerates revenue with its rapid analysis of payer mix, admission rates, annual volumes, information systems, and number of providers and facilities. 

Emergency Medicine Advisory Solutions

Ventra Health offers a perfect blend of advisory, practice administration and technology solutions. If you are looking for more than RCM services, tap into Ventra Health’s Advisory Solutions to evaluate hospital-based physician services. Among the advantages you’ll experience:

  • Reverse costly, time-consuming practice inefficiencies.
  • Audit charts to pinpoint revenue-draining gaps and errors. 
  • Evaluate compensation plans for fairness, market competitiveness, and recruitment and retention potential. 
  • Develop creative approaches to managed care and facility contracting. 
  • Analyze, assess, evaluate and re-engineer revenue cycle management for maximum financial gain. 
  • Generate revenue via more accurate, timely clinical documentation.

Here’s how you can win with Ventra Health:

Make the Most of Your Managed Care Contracts

Access Ventra Health’s seasoned team of managed care contract negotiators to secure the best contracts, design out-of-network strategies, and analyze rates against Medicare benchmarks The result: Reimbursement gains and enhanced Emergency Medicine revenues. 

Take on Dispute Resolution and Arbitration

Let Ventra Health guide you through balance billing regulation and out-of-network payer disruption. Ventra Health is your early warning system for declines in OON reimbursement. Our business intelligence tools deliver accurate, real-time alerts. 

Streamline and Accelerate Dispute Resolution

Take advantage of Ventra Health’s streamlined process for dispute resolution and arbitration. Benefit from a faster, more flexible, and less costly alternative to litigation. Participate in solution development and get control over financial outcomes. 

Analyze Practice Potential in Finances, Operations, Clinical Care

Measure demand for services, and your capacity to meet that demand. Cut costs and boost efficiency with regular check-ups on policies, practices, and procedures. The benefit: A more streamlined, efficient, and productive Emergency Medicine practice.

Re-Engineer Your Board

Rethink your board’s structure, leadership, size, and deliberative process to uncover new models for business and clinical care and complement new and evolving trends in medicine and healthcare.

Track and Evaluate Compensation

Find out where you stand--and where you should be—on compensation. Join forces with Ventra Health’s compensation specialists to adjust or transition existing compensation plans or structure new plans around quality incentives.

Look to Your Leaders

Create a succession planning process that drives leadership development and continuity. Create leaders with the right blend of knowledge, skill, and experience in finance, operations, and clinical care via education, mentoring, and coaching.  

Secure a Payer Appeal Partner 

Ventra Health launches, tracks, analyzes, and evaluates appeals to payers, liberating you from a cumbersome, time-consuming process. The goal: maximum reimbursement and financial gain for the practice. 

Technology Solutions for Emergency Medicine 

Ventra Health tracks performance by comparing Emergency Medicine practice data with industry benchmarks. Its suite of business intelligence solutions transform data into the kind of input that drives timely, evidence-based practice decisions.

With Ventra Health you get the tools you need to catapult your practice to new levels. Ventra Health’s reports incorporate Key Performance Indicators (KPIs), personalized and customized to fit your specialty, location, and payer mix.

Discover where you stand on variables like trends in payer mix, volume, and disposition, accounts receivable days, and aging accounts receivable by responsible party. Also available are statistics on collections, E & M distribution with benchmarks, and potential documentation downcodes. You’ll benefit from chart and bank statement reconciliation, benchmarks for ancillary procedures, and Left Without Being Seen/Left Without Treatment (LWBS/LWOT) tracking. You’ll know where providers stand as you review metrics and statistics on provider productivity and patient interactions. 

Ventra Health eases access to practice data via a series of easy-to access dashboards like these: 

  • Access the information that matters most via separate executive and provider dashboards.
  • Calculate bonuses via a scorecard on merit-based incentive system (MIPs). 
  • Identify your practice’s evaluation and management (E/M) code distribution. 
  • Compare your practice’s documentation proficiency to national practice averages. 
  • Reconcile 100 percent of charts.
  • Manage provider enrollment holds. 
  • Monitoring and evaluating charting trends. 
  • Access training on clinical documentation. 

Finding the Right RCM Partner

Practices need to take a closer look at KPIs— from clean claim rates to collections per visit, know how KPIs are trending and how a practice could boost clinical and business performance.

Working with an RCM partner like Ventra Health can improve financial performance and patient satisfaction scores, while extending performance of practice staff.  

Practices seek partners like Ventra Health when they experience revenue declines driven by changing payer rules or challenges in contracting and credentialing. The solution rests in having a clinical and business vision for the practice while optimizing billing and coding.  

Practices who hire coders and billers must keep up with training and the latest coding changes as well as securing payment on claims.

Your RCM partner should know the specialty of Emergency and Hospital Medicine, your electronic health record (EHR) system, and new and emerging technologies that could boost practice performance. 

Ventra Health can ensure that you bill every day to avoid aged accounts receivables. 

Physicians should look at Ventra Health as an extension of the practice, not as a separate entity. Make sure your RCM partner is available for troubleshooting, support, and regular meetings. 

While cost is a factor in finding and engaging an RCM partner, look for an ability to gather data, share insights, and engage with third parties.