Revenue Cycle Management Services
We streamline healthcare revenue processes with our efficient Revenue Cycle Management (RCM) services, optimizing every stage from patient registration to final payment. Leveraging advanced technology and industry best practices, we enhance claim accuracy, accelerate collections, and reduce denials. Our comprehensive RCM solutions improve financial performance, reduce administrative tasks, and boost patient satisfaction, allowing providers to focus on delivering exceptional care.
Key Benefits of Revenue Cycle Management Services
End-to-End Efficiency
Seamlessly manage the entire revenue cycle with our integrated solutions that streamline processes and reduce errors.
Advanced Technology
Leverage cutting-edge tools and analytics to optimize claims processing and financial management.
Expert Team
Benefit from our experienced professionals who are dedicated to maximizing your revenue and minimizing your stress.
Customized Solutions
Receive tailored strategies that align with your specific needs and objectives, ensuring optimal results.
Revenue Cycle Management Services
Appointment Scheduling
- Schedule appointments
- View patient information
- Assign time slots to doctors
- Check doctor’s availabitlity
- Manage no-show appointments
- Appointment cancellation
- Sender reminder SMS or emails to patients
- Online patient self-scheduling
- Appointsment rescheduling and confirmation
- Integration with EHR systems
- Manage walk-in appointements
- Real time reporting
Patient Registration
- Online and in-person patient registration
- Collection of demographic and contact info
- Insurance information collection
- Data accuracy validation
- Pre-registration via patient portals
- Real-time updates to EHR
- Integration with eligibility systems
- Consent form management
- Custom workflows for providers
- Secure storage of patient data
Eligibility & Benefits Verification
- View patient information
- Real-time eligibility checks with payers
- Benefits verification for covered services
- Out-of-pocket cost estimations
- Coordination of benefits (COB) checks
- Pre-authorization checks
- Automated payer-specific eligibility checks
- Integration with registration and billing systems
- Reporting eligibility discrepancies
Utilization Review
- Medical necessity evaluations
- Concurrent and retrospective reviews
- Pre-certification and pre-authorization checks
- Identification of under/over-utilization
- Case management integration
- Reviews for hospital admissions
- Utilization tracking
- Compliance with payer requirements
- Appeals management for denied services
Referral and Authorization
- Referral management and tracking
- Automated submission of authorization requests
- Pre-authorization verification
- Real-time status updates
- Proactive follow-up
- Document management for approvals
- Emergency authorization processing
- Renewal of expiring authorizations
- Reporting on referral/authorization bottlenecks
Describing Charges
- Accurate charge capture management
- Transparent documentation of procedures
- Automatic charge code assignments
- Regular updates to coding descriptions
- Charge reviews for compliance
- Compliance with ICD and CPT standards
- Custom charge descriptions
- Charge reconciliation with patient records
- Charge auditing
Medical Coding
- Claims generation
- Payer-specific billing guidelines
- Patient invoicing and billing
- Re-submission of rejected claims
- EOB reconciliation
- Insurance follow-up for unpaid claims
- Reporting on billing cycle performance
Medical Billing
- Claims generation
- Payer-specific billing guidelines
- Patient invoicing and billing
- Re-submission of rejected claims
- EOB reconciliation
- Insurance follow-up for unpaid claims
- Reporting on billing cycle performance
Charge Posting
- Real-time charge posting
- Automated batch posting systems
- Posting accuracy checks
- Reconciliation with submitted claims
- Adjustments for payer allowances and write-offs
- Posting for multiple providers and locations
- Integration with billing systems
- Reporting on posting trends
Submitting Claims
- Timely submission of claims to payers
- Batch submission processing
- Claims scrubbing
- Electronic claim submission and tracking
- Compliance with payer-specific rules
- Continuous monitoring for rejected claims
- Re-submission of denied claims
- Real-time claim status updates
Clearinghouse Denials
- Claim validation
- Denial reason analysis
- Automated clearinghouse integration
- Denial prevention strategies
- Real-time denial tracking
- Denial management workflows
- Automated alerts for denied claims
Payment Posting
- Automated payment posting
- Manual payment reconciliation
- EOB (Explanation of Benefits) processing
- Payment variance analysis
- Payer-specific payment posting rules
- Handling of refunds and overpayments
- Posting for different payment types
- Reporting on payment posting trends
Denial Management
- Root cause analysis of denials
- Reworking and resubmitting denied claims
- Denial follow-up with payers
- Denial reporting and analytics
- Appeals for overturned denials
- Automation of denial management processes
Secondary Filing
- Coordination with primary payers
- Timely submission to secondary payers
- Verification of secondary payer eligibility
- Tracking of secondary claim status
- Real-time secondary payer updates
- Reporting on secondary filing outcomes
Accounts Receivable (AR)
- Aging AR tracking
- Automated AR follow-up
- AR reconciliation
- Payment plans and patient financing options
- Reporting on AR trends and metrics
- Bad debt management
- AR risk assessment
Appeal Procedure
- Filing appeals for denied claims
- Documentation for appeals
- Real-time tracking of appeal statuses
- Communication with payers for appeals
- Appeals reporting and analytics
- Appeals management workflows
Patient Billing & Collections
- Timely patient invoicing
- Payment collection follow-ups
- Payment plans and installment options
- Patient billing reminders
- Online bill payment options
- Handling of patient disputes
Reporting & Analysis
- Revenue performance reports
- Key performance indicator (KPI) dashboards
- Denial and rejection analysis
- Patient billing trends
- Financial forecasting based on current trends
- Custom reporting and analytics solutions
- Benchmarking against industry standards
Charge Capture Optimization
- Real-time charge capture
- Charge reconciliation with services rendered
- Custom charge capture workflows
- Charge auditing for accuracy
- Integration with EHR and billing systems
- Continuous charge capture improvement
Prior Authorization Management
- Automated prior authorization requests
- Verification of authorization requirements
- Real-time tracking of authorization status
- Communication with payers on authorization requests
- Reporting on prior authorization delays
Price Transparency Compliance
- Clear communication of service costs
- Online access to pricing information
- Compliance with price transparency regulations
- Automated price estimation tools
- Reporting on price transparency compliance
Revenue Cycle Analytics
- Financial performance reporting
- Revenue cycle trend analysis
- Custom KPI dashboards
- Predictive analytics for revenue cycle optimization
- Benchmarking against industry standards
Strategic RCM Consulting
- Workflow assessment and redesign
- Technology integration consulting
- Revenue cycle optimization strategies
- Compliance consulting
- Financial forecasting and planning
- RCM training and development
Process of Revenue Cycle Management
Efficiency through Automation
Our team leverages advanced RCM software to automate routine tasks such as appointment scheduling, eligibility verification, and claims submission. This reduces errors and accelerates the process.
Compliance and Accuracy
We stay updated with ever-changing regulations and ensure all our services, such as medical coding and prior authorization management, are fully compliant with industry standards.
Data-Driven Decision Making
Our Revenue Cycle Analytics and Reporting services provide actionable insights into your financial performance. This allows us to continuously improve processes, optimize charge capture, and reduce denials.
Dedicated Expertise
From payment posting to denial management and patient collections, our team of RCM experts works closely with your organization to identify bottlenecks, improve workflows, and enhance financial performance.
Strategic Consulting
Through our RCM Consulting services, we partner with your organization to develop a strategic plan tailored to your unique needs. We help you optimize revenue cycle processes, maintain compliance, and improve overall efficiency.