Andy Jones, Chief Marketing Officer of American Exchange, American Exchange
Andy Jones, Chief Marketing OfficerUncompensated care has been a challenge for all organizations providing health services, and it could get worse when the public health emergency ends and millions lose Medicaid eligibility. It has a direct effect on the financial stability of both patients and facilities. This is why healthcare providers need a revenue cycle management and insurance specialist like American Exchange. The company is one of few service providers that manages both the front end–healthcare enrollment and policy management–and the back end– medical billing, coding, insurance claims and denials, and credentialing. Their services are poised as win-win solutions, connecting eligible, uninsured individuals with affordable insurance plans to help providers and clinics mitigate the challenges of uncompensated patient care.

“Our long-standing expertise enables us to effectively handle back office administrative tasks like medical billing and also help healthcare providers link patients to affordable healthcare plans or health agencies,” says Andrew Jones, VP of Marketing of American Exchange.

Anchored to its mission of holding strong expertise in medical claims processing, billing, and the accounts receivable (A/R) processes, American Exchange helps clients improve their revenue cycle management workflow efficiency. The firm functions primarily as an extension of the client’s internal administration staff, mitigating staffing shortages, seasonal fluctuations, and billing backlogs. In addition, American Exchange lends a helping hand to organizations that would like to expand access, but don’t have time to manage the credentialing processes of different carriers and insurance programs.

American Exchange: Reducing A/R Days And Uncompensated Care Costs

One way the firm tackles uncompensated care is by conducting insurance discovery to retrospectively check for insurance coverage at the time health services were provided.If coverage is found and it’s within the billable period, which varies by carrier and program, American Exchange can submit a claim to get reimbursement for providers.

When no insurance is found, American Exchange can enroll eligible patients in Affordable Care Act (ACA) or Medicare health plans, or direct them to Medicaid or CHIP programs, enabling patients to get coverage. In some cases, the coverage may be retroactive, enabling clients to seek reimbursement. This approach ensures that eligible patients are insured and effectively preempts unremunerated care.

Essentially, all our endeavors focus on listening to clients' needs and offering customized solutions based on their specific requirements.

Whether clients seek short-term, long-term, or a full spectrum of services, the firm begins by listening to the needs of each client and assessing their processes to identify what services are needed. If a full-service solution is warranted, American Exchange starts with patient intake assessment. Next, it evaluates the rate of patients with or without insurance. Once services are provided, a professional coder initiates the reimbursement process, including medical coding, claims scrubbing to ensure claims are submitted right the first time, and claims submission. This reduces the amount of time for providers to receive reimbursement.

The company also provides denial management services in the rare instance a claim is denied. For example, if patients have carriers with a higher denial rate, American Exchange works with them to process the appeals for coverage. Finally, they look at A/R management to follow up with processing statements and put patients on payment plans.

“By auditing the accuracy of accounts on a daily basis, we can make immediate process improvements that have a positive impact on revenue. We are passionate about your revenue like it is our own,” says Bridget Samojeden, Director of the Revenue Cycle Management Department at American Exchange.

The firm also provides robust data analytics and financial reporting to help organizations improve their overall A/R process. This comprehensive approach results in more financially sustainable and efficient clients. For instance, one of their clients based in Miami struggled with mounting uncompensated care. However, American Exchange reduced their uncompensated care by 20 percent. As a result, the client witnessed a considerable improvement in their financial stability.

Synonymous with many such client success stories, the company has a track record of increasing the collection rate by 50 percent and boosting timely payments by 30 percent. American Exchange also reduces A/R days by consistently achieving a 98 percent clean claims processing rate. In essence, all their endeavors tie back to the grounding principle of listening to clients, then offering custom solutions that benefit both hospitals and patients.