At Revenue Cycle Management, a leading Revenue Cycle Management Company, we are dedicated to revolutionizing revenue cycle management for businesses across industries. With a proven track record of optimizing financial processes, we leverage cutting-edge technology and industry-leading expertise to ensure our clients maximize their revenue potential.
Our team comprises seasoned professionals in healthcare finance, billing, and technology, driven by a singular mission: to simplify and enhance revenue cycle operations. We understand the complexities that come with managing finances and prioritize tailoring our solutions to meet the unique needs of each client.
When a patient comes in, they undergo pre-authorization. The physician’s office pre-approves the patient of certain treatments and prescription drugs by this process.
INSURANCE ELIGIBILITY & VERIFICATION
The process is downright demotivating over the phone because it demands a lot of patience. Therefore, a set function must be a part of the revenue cycle management (RCM) software to cater to it.
ICD CODING AND CHARGE POSTING
When the patient checks in at the office, the visit transforms into a set of codes. There is a high probability of human error in these codes, which is why professional medical coders are the go-to people for it.
Submission of claims is the vital stage in the overall process because the reimbursement directly depends on it. If it is flawed, the chances for reduced payments or outright denials increase.
For the claims which suffer rejection, they are resubmitted soon after they are scrubbed for coding mistakes. The resubmissions or the process of appeals demands critical screening with a finger on the pulse of the latest coding guidelines.
When there is reduced reimbursement from the payers, it means the health plan does not cover all the services. So, the billers have to send those outstanding payments to the patient and follow-up.
REIMBURSEMENT FOR THE SERVICES RENDERED
It is time for the insurance company to pay up. The payers match the procedures with their charges under the coverage limit.
OUT OF POCKET (CO-PAYMENTS AND DEDUCTIBLES)
Every health plan comes with a deductible and a co-payment. Some have high and some have low deductibles.
❖ Cutting-edge technology
❖ Cost-cutting benefits up to 70%
❖ 100% HIPAA-HITECH compliance
❖ Strong denial management knowledge
❖ Real-time audits and custom reporting
❖ Expert handling of aging accounts receivable
❖ Turnaround time less than 48 hours max
❖ Reasonable service fees with no hidden cost
Advantages of Outsourcing Revenue Cycle Management (RCM) Services
Maximize Revenue and Streamline Operations with Expert RCM Outsourcing
Expertise and Efficiency
RCM outsourcing brings in specialized expertise. Experienced professionals handle intricate billing, coding, and collections, ensuring accurate and efficient processing of claims.
Outsourcing revenue cycle management reduces overhead costs associated with in-house staff, software, training, and infrastructure. It optimizes expenses and allows for a predictable cost structure.
Enhanced Cash Flow
Efficient revenue cycle management services lead to faster claims processing and reimbursements. This accelerates the revenue cycle, ensuring a steady cash flow and financial stability for healthcare practices.
Compliance and Risk Management
Outsourcing partners are well-versed in healthcare regulations. They keep up with compliance changes, mitigating risks of non-compliance and reducing the potential for penalties or audits.
RCM outsourcing often provides access to cutting-edge technology and analytics tools. These resources streamline processes, improve accuracy, and offer valuable insights for performance optimization.
Focus on Core Services
By outsourcing RCM functions, healthcare providers can redirect their focus towards core patient care and operational improvements. This shift enhances service quality and patient satisfaction while allowing staff to concentrate on critical tasks.