Revenue Cycle Management – RCM
Revenue Cycle Management – RCM
We offer smart solutions to a complicated process!
Being a medical RCM company, managed by qualified healthcare accountants, we fully understand how complex the RCM process is.
The RCM process is both labor and process intensive.
Our smart RCM Solutions have segregated each of the tasks of the RCM process into stand-alone tasks; we assign adequate resources to every one of the many RCM tasks.
We have fully trained teams to focus on each of the following tasks of the RCM process –
Front desk training
Train the front desk staff to collect accurate Primary and Secondary Insurance information from the patients.
Train front desk staff to correctly identify and collect all patient responsibilities – Co-pay, Co-insurance, Deductibles & Patient balances
We set up a fool-proof front desk daily close procedure so that every penny collected upfront is accounted for properly.
Coding
We have an expert team of coders who can review the progress notes to make sure that the information in the medical chart matches the submitted claims.
We constantly educate the clinical staff and Physicians about correct documentation.
Billing
We have processes in place to track claims so that every billable patient encounter is billed out.
We assign enough resources to each client so that all claims are reviewed and billed out within 48 hours.
Payment Posting
Our payment posting team post the payments daily.
As this team post the payments, they alert the billers of denials that they see by updating the denial log in real-time.
We set up ERA / EFTs wherever possible so that the practice can receive payments faster and the payment posting is quick.
Denial management
We have set up a separate workflow for denial management which is an important RCM task.
The denial log prepared by our payment posters is sent to our billers daily for review and to appeal all denied claims. This results in prompt rework and appeal of all denied claims.
Reconciliation to Bank Statement
As healthcare-focused accountants, we understand that for patient
balances to be accurate, the payments posted to the billing software
must match the bank deposits to the last penny.
We perform weekly payment reconciliations so that patient balances
are always accurate.
Accounts receivable (AR) management
We are fully aware that the AR balances sitting in the patient ledgers are money that will be lost without constant follow up.
We review all the older balances and follow up with insurance companies to get payment status on all the unprocessed claims.
Accounts receivable calling (AR Calling)
Most clinics lack resources to do AR Calls because it is a time-consuming process.
We have a dedicated team of AR callers who call insurance companies and follow up on unpaid claims regardless of the time it takes to complete these AR Calls (insurance companies are notorious for long call wait times for such follow-up calls)
Reporting
As healthcare focused accountants, we understand how important timely management information reports are to the business owners.
We identify the important reports that will highlight the key metrics to business owners every month.
We summarize the major trends for the management so that these trends are understood, and corrective action is promptly taken when needed.
Revenue improvement
We are constantly monitoring the payment landscape to learn about revenue improvement opportunities.
When a revenue Improvement opportunity arises, we immediately review the opportunity and make recommendations to our clients and help them to implement the new services to realize increased revenue.