Revenue Cycle Management
Revenue Cycle Management (RCM) is a financial process that healthcare providers use to track, bill, and collect payments from patients. It’s a critical part of healthcare administration that ensures medical facilities are reimbursed for their services.
RCM includes all the administrative and clinical functions that contribute to the patient care revenue cycle, from the initial appointment to the final payment.
Some of the steps in the RCM process include:
Patient registration: Gathering patient demographic and insurance information, verifying eligibility, and establishing financial responsibility
Claims submissions: Submitting claims to insurance companies
Patient billing: Billing patients for services rendered
Collections: Collecting payments from patients
Outsourcing RCM can help ensure that billing processes are accurate and efficient, which can improve cash flow. Technology can also help drive RCM to the next level of effectiveness. For example, online patient portal systems can help collect patient payments without the need to generate multiple statements.
Our Services
We serve all your needs under one roof
Eligibility and Benefits Verification
Eligibility verification is the process of verifying a patient;s insurance in terms of Validity (Active/Inactive), coverage of benefits
Referrals and Prior Authorization
Our team is knowledgeable in each and every aspect of health insurance, healthcare terminologies and medical/surgical procedures, our verification specialists work with payers as well as patients
Provider Enrollment and Credentialing
Insurance credentialing services help to enhance the entire process of revenue cycle management. An efficient and streamlined workflow will lead to lesser claim denials and an improved patient experience.
Clinical/Utilization Reviews
We prepare concise clinical reviews of the patients by viewing EMR and including the abnormal findings of the patient to be sent to the facility for approval from converting OBS and ER patients to Inpatient
Medical Records Abstraction
Medical Record Abstraction services deliver fast, accurate abstraction of clinical data components that document the provision of compliant care for HEDIS® reporting, and other quality measurement needs. This service creates a base medical record for a patient by going through all the patient’s old medical charts.
Remote scribing
“Spend More Quality Time With Patients, Not Entering Data” Electronicmedical records (EMRs) improve efficiency and make medical information easier to share with patients, providers, and payors. However, all of that data entry takes time away from patients and adds time to a provider’s busy schedule. Our highly trained, remote medical scribes can help.