Revenue Cycle Management
Qualified consultants with operational experience in Patient Access, Health Information Management and Patient Financial Services.
Knowledge of advanced technology for the automation of repeatable processes and the validation of accurate, and compliant account information.
The Revenue Cycle Model:
Complete RCM, Denial Management, Payment Posting & Pre-Insurance Verification.
In the entire process the key is efficiency. We deliver results on time to keep you profitable at all times.
Revenue Cycle Model
Our eligibility verification feature helps in minimizing any revenue loss, by pre-checking insurance. The check is for Medicare, Medicaid and other commercial/ institutional payers. For non-participating payers in eligibility check, calls to insurance are
Before sending out the claims to insurances, they are scrubbed for correcting any data errors such as insurance setup errors, referring provider details etc. The various procedures and diagnostics are also checked for errors in the light of correct coding initiatives (CCI) and local medical review policy (LMRP).
Majority of the claims go electronically, as our software has integrated clearing house. So you get reimbursed on time, with most of the payers. You are also given the option to receive the remittance electronically. Thus making the whole process paperless and contributing our bit to the environment.
Timely A/R Followup
An insurance based claims matrix is created. The AR team works on all claims that cross the 15 day period, thus the payment time of 80% of the claims fall within the 30 day period. We have a dedicated team working on all denials and rejections to keep your payment cycle in good shape.
The payments received are verified against your contract with the insurance to make sure you are paid as per the agreement. All the payments are appropriately posted and adjusted as per the contractual agreement. Patient billing is done at the time of payment posting. We analyze data to make sure that claims are not denied by a payer for a specific reason, to avoid any mass denials and to filter our procedure to catch such errors.
We offer you concise reports on a weekly and monthly basis to give you an overview of the practices current operation. You also have access to the billing system, to review reports as and when desired. Reports are also available as per your need and can be customized as per your suggestions. The format is usually excel spreadsheet and pdf’s for easy viewing and printing