Axea Solutions: A Holistic Approach to RCM

Susan Gatehouse, CEO, Axea Solutions

For healthcare entities, revenue cycle management (RCM) is a combination of several complex processes starting from patient preauthorization to payment processing. The steps involved, to ensure that there is a continuous inflow of revenue, hospitals and healthcare institutions need to align the clinical services to patient care as well as medical documentation and claims approvals. The integrity and accuracy of the data has a tremendous impact on revenue cycle management, quality initiatives, and clinical outcomes. The siloed structure of most healthcare organizations hinders agile information management, creating a lack of information and communication within the revenue cycle that can impact payment of claims. With a streamlined process, Axea Solutions collaborates with healthcare systems, hospitals, and clinics to assist in improving their clinical documentation, coding, and RCM and provide an all-encompassing approach in calibrating the data to accurately reflect a patient’s encounter. “We work toward the overall outcome, in terms of the value we can bring in transactions and determine the necessary resources we need to hone for overall improvement,” states Susan Gatehouse, Founder and CEO of Axea Solutions.

The company functions around three major competencies in ensuring a robust RCM that supports data quality, workflow efficiency, and appropriate reimbursement. Axea provides clients with the ability and knowledge about healthcare initiatives to facilitate a cohesive work environment along with seamless assessment and review of the accuracy of medical codes using its web-based audit management platform. Following thorough scrutiny, the company ensures coding accuracy along with the quality of data. They also offer an online coding education and training platform via Axea Academy to enhance the knowledge and productivity of coding teams and help them better comprehend the quality of the diagnosis and procedural coding.

The Axea Academy platform was specifically developed to support comprehensive education to coders and clinical documentation improvement specialists. With the ability to generate real-time reporting for evaluations, cross-train coders and provide specialty service line training; Axea Academy serves as a powerful management tool for Coding Managers and RCM leaders. The other area of focus for the company is clinical documentation improvement. Axea renders its expertise in understanding how legacy processes work, identify shortcomings, and provide up-to-date information and knowledge to improve processes according to the needs of clients, compliant to the regulatory norms. What they further do is look into departments and processes within the healthcare organizations that need process transformation. The company deals with the management of denied claims by reviewing the denial and identifying the precise documentation or coding issues. With their discoveries, the Axea team formulates remediation strategies that ensure accurate coding, clean claims and fewer denials.

In addition to these core functionalities, the company offers edit remediation services. When it comes to out-patient services, most of the charges are generated electronically from a chargemaster, which results in billing edit. In such a scenario, before a claim is submitted to the payer, it is run through an automated auditing system which encompasses national edits. Axea Solutions rectifies the billing document through formulated strategies, prior to billing. This is a highly complex, granular approach to ensure data accuracy and in turn, reduce the amount of denied claims and delayed payments.

With a wide scope of expertise in providing a well-functioning RCM within health care institutions, the company is looking ahead at maintaining proficient data management and integration capabilities which will enrich data ultimately supports an organization effort in submitting a clean claim and archiving verified, quality data.Axea Solutions is also working toward automating workflow for ensuring speed and efficiency among the coders. Their holistic approach, with detailed assessments, innovative methodologies, and services help to improve clinical documentation and coding accuracy. In the line of its services, the company has initiated hierarchical coding categories within healthcare systems and has also increased awareness of the importance of data accuracy in both the outpatient and inpatient arena. Axea Solutions thus continues its mission to provide a streamlined patient financial workflow and foster the financial success of its clients.

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Company
Axea Solutions

Headquarters
Cumming, GA

Management
Susan Gatehouse, CEO

Description
Axea Solutions is one of the pioneers in the revenue cycle management realm. It provides solutions and services across various healthcare organizations and clinics. The company stays with its clients throughout the entire journey starting from patient registration, to providing medical services, all the way to claims, processes and payments. Axea Solutions has expertise around coding accuracy, clinical documentation improvement and also claims denial management. The company has a proactive and holistic approach and aims to solve the bigger issue of discontinuity in the flow of revenue, while also maintaining a strong patient financial workflow