Revenue Cycle Management
Our Revenue Cycle Management Services
Healthcare is an incredibly complex industry to manage from an accounting perspective. Without proper management of payer contracting, coding, and billing, organizations can face a myriad of issues, such as lost revenue, delayed cash-flow, and compliance risks. Our RCM solutions provide the expertise and reliability necessary to help optimize your top line so you can focus your attention on providing the best possible care for your patients. With our RCM solutions, you can have peace of mind knowing that your organization’s finances are in good hands.
Working with us is easy and quick, requiring no change in your current Electronic Medical Records (EMR) or Practice Management (PM) systems. Most practices are on-boarded and ready for use within 2-4 weeks. Our teams of specialists for each area of the revenue cycle have extensive experience in most specialties, so you can be sure that you're working with experts who understand your unique needs.
Our tech-enabled solutions, experience, and talented people optimize financial results and provide business support to physician groups allowing them to focus on treating patients, scaling their business, and staying independent.
Ensure that services, fees, and charge capture are set up correctly in order to avoid missed or under-billing. Set-up and manage third-party services for patient statements, online patient payments, automated e-filing of claims to insurance companies, and secure electronic payments from payers. Monitor and analyze billing trends to identify areas of improvement and develop strategies to maximize collections.
Review charges for services and ensure accuracy of information before billing out. Monitor for any potential problems that may lead to denials or rejections, and take corrective action prior to billing. Ensure minimal lag times between completion of services and billing out of services. Communicate any problems encountered and take corrective action to ensure smooth billing process.
Work and correct denials and aged claims timely. Monitor and analyze denials, identify trends and take corrective action. Determine root cause of denial and implement corrective actions to avoid repeat denials in the future. Review and monitor claims to ensure accuracy and timely filing. Resubmit denied claims as appropriate. Communicate with and educate clinical and office staff on medical necessity, payer rules, and documentation guidelines. Monitor payer websites for updates and changes to reimbursement guidelines. Review and update coding guidelines and protocols. Maintain knowledge of payer regulations and coordinate with payers to resolve any discrepancies. Participate in payer audits and respond to any requests for information.
Set up third-party paper and online statements, as well as online payment options. Staff and manage patient inquiry options, such as voice, Chat Box, and SMS. Work with non-resource patients to determine Medicaid eligibility.
Monthly reconciliation and reporting of key practice data, including patient demographics, visit data, charges and payments, insurance information, and more. Dashboards to track performance and key performance indicators (KPIs), such as outstanding balances, aging accounts, patient volume, collection rate, and more. Feedback and analysis to improve practice performance and optimize collections, such as identifying accounts with potential billing errors and areas of potential revenue leakage.
Why choose us
In today’s challenging healthcare environment, our unique blend of people, processes and technology reduce administrative burdens, increase collections, reduce costs and allow you to focus on what matters - patient care!
Our company was founded in 2003 with the intent of helping healthcare providers address the persistent problem of shrinking revenues and rising costs. We hold ourselves up to the strictest of ethical standards and take pride in delivering exceptional, innovative, personalized professional services.