Revenue Cycle Management FAQ

SHERLOQ Solutions has over 109 years of experience in the business.  

SHERLOQ Solutions serves a wide range of healthcare providers, with a primary focus on major hospitals, health systems, and physician groups. This FAQ focuses on their services for hospital systems.  

They adhere strictly to HIPAA, FDCPA, TCPA, and other federal and state regulations. They are also SOC 2 Type II certified, ensuring high standards for data security, availability, and confidentiality.  

SHERLOQ offers seamless integration with your existing billing and Electronic Health Record (EHR) systems.  

Their team consists of certified professionals with credentials such as CRCS, CRCR, CPC, CPB, and RHIA. A number of staff have 20 and 30 plus years tenureship with Sherloq Solutions which reflects a commitment to continuous education and expertise.  

They utilize advanced technology like AI Bot Assistants, multi-platform auto-dialer systems, secure payment portals, and advanced analytics to ensure efficient and effective recovery processes.  

SHERLOQ Solutions is nationally licensed to operate in all 50 states.  

They maintain a 97% patient satisfaction rating, emphasizing a compassionate and patient-friendly approach in all their services.  

Key benefits include increased reimbursement rates, reduced write-offs, faster claim resolution, and improved patient experience, all while ensuring regulatory compliance.  

These are end-to-end services designed to maximize reimbursements for hospitals by pursuing outstanding insurance claims and overturning denials, thus
minimizing revenue leakage.  

Their team crafts and submits strong, data-backed appeals using their deep knowledge of payer policies, clinical documentation, and contract terms to ensure claims are paid accurately and on time.  

They perform denial analysis to identify root causes and trends in payer behavior and coding. This helps in correcting systemic issues and preventing future denials.  

By actively pursuing aged claims, slow pays, and underpayments, they help to accelerate insurance recovery and reduce the number of days in Accounts Receivable (A/R).  

Yes, they have expertise across all payers, including Medicare, Medicaid, Managed Care, and Commercial Plans.  

It offloads the administrative burden of insurance follow-up and denial resolution, allowing your team to focus on core operations and patient care.  

SHERLOQ provides transparent, custom reporting and performance dashboards tailored to your hospital’s specific metrics, goals, and payer mix.  

Expert knowledge of the constantly changing payer policies and regulations is crucial for crafting effective appeals and ensuring compliance, which leads to higher reimbursement rates.  

By identifying trends and systemic issues, they work to correct them, ensuring that the hospital captures every dollar it has earned from payers. 

The primary goal is to recover the full revenue that healthcare providers deserve by diligently resolving unpaid claims and efficiently appealing denials.  

It’s a service that helps hospitals secure patient payments upfront by addressing cost estimates, out-of-pocket expenses, and payment options before care is delivered.  

Statistics show that providers have a 70% chance of collecting payments before or at the point of service, but that number drops to just 30% after discharge. Pre-service collections are critical to reducing bad debt.  

Patients receive clear cost estimates upfront, which reduces billing surprises. They are also offered flexible payment options and better financial counseling.  

It significantly improves cash flow by securing co-pays, deductibles, and out-of-pocket balances before service, which increases point-of-service collections.  

Yes, by identifying and resolving insurance coverage issues prior to service, it helps to minimize costly claim denials and the need for rework.  

It relieves internal staff from time-consuming insurance verification and financial discussions, allowing them to focus on care coordination and enhances compliance with price transparency regulations. It also helps prevent late cancellations and no-shows, optimizing schedules.  

It relieves internal staff from time-consuming insurance verification and financial discussions, allowing them to focus on care coordination and enhances compliance with price transparency regulations. It also helps prevent late cancellations and no-shows, optimizing schedules.  

Patients are offered various solutions, including custom payment plans and digital payment options through secure online portals.  

Proactive and compassionate communication helps patients avoid financial surprises, make informed decisions, and feel more confident and satisfied with their
care experience.  

  The key benefits include increased upfront revenue, reduced A/R days, decreased bad debt and write-offs, and improved overall financial performance.  

These services help hospitals recover outstanding patient balances early in the revenue cycle, before they become bad debt, while prioritizing a positive patient experience.  

It accelerates cash flow by engaging patients with self-pay accounts early, leading to the recovery of more revenue, faster.  

They use a compassionate recovery approach with multi-channel communication (calls, emails, texts, mail) to preserve patient satisfaction. HIPAA-trained representatives provide respectful, personalized support.  

By handling patient outreach and follow-up, SHERLOQ’s cost-effective model reduces the need for additional in-house resources, freeing up internal teams to focus on core operations.  

Patients receive user-friendly statements and branded payment portals that are tailored to the specific hospital, making it simple to view balances and make payments.  

SHERLOQ engages patients through their preferred methods—text, email, phone call, or mail—to increase response rates and overall satisfaction.  

The service is designed to improve the patient experience by offering clear communication, flexible payment options, and respectful support, which fosters trust and protects the hospital’s reputation.  

By proactively reaching out to patients and resolving balances before they age into bad debt, this service significantly reduces bad debt write-offs. 

 Early Out Self Pay All processes are fully compliant with HIPAA, FDCPA, and other healthcare regulations to ensure data security and peace of mind.  

Early Out Self Pay As patients take on more financial responsibility, early engagement is crucial to effectively collect self-pay balances without damaging the Provider-patient relationship.  

This is a specialized service focused on recovering revenue from aged, written-off, and complex accounts that would otherwise be lost, while maintaining professionalism and compassion.  

SHERLOQ’s healthcare-focused collection strategies are proven to maximize yield and achieve higher recovery rates on difficult-to-collect accounts.  

 Their trained representatives handle every patient interaction with empathy and professionalism, acting as an extension of the hospital’s business office to preserve brand reputation and community trust.  

They leverage advanced technology such as scoring models, skip tracing, AI, and omnichannel engagement tools (text, email, phone) for smart and effective collections.  

They ensure full adherence to FDCPA, HIPAA, TCPA, and all applicable federal and state collection laws, which reduces risk for the hospital.  

No, they offer customized workflows and tailored collection strategies aligned with each hospital’s specific goals and requirements.  

As a SOC 2 Type II certified and HIPAA compliant organization, SHERLOQ meets rigorous standards for data security, availability, and confidentiality, ensuring patient and financial data are fully protected.  

They prioritize positive patient engagement and have a 97% patient satisfaction rating, ensuring that even during the collection process, patients are treated with respect.  

With over 50 years of proven collection performance and serving over 1,200 active clients, they have a long history of being a trusted, effective, and compliant partner in the healthcare community.  

Outsourcing allows the hospital to focus on its primary mission of patient care, while a specialized, compliant, and effective partner handles the complexities of recovering outstanding balances.