Revenue Cycle Management

Up to date claims submission

Systematized revenue cycle management in healthcare is considered as the key to the sleek administration for hospitals and organization. We achieve this by using intelligent scripts that automatically extract ICDs and CPTs from bills, checks coding related compliance, modifier usage and then enter into a Practice Management System. We benchmark ourselves at submitting claims two days prior to the date of service. This results in systematized revenue cycle and a regular income flow. The replacement of the traditional manual entering with automation guarantees greater efficiency. This saves us a massive amount of resources and time.

Focus on quality

Quality is our main focus. We standardize our self by implementing the latest technology and embracing our knowledge into executable actions in the key areas of the revenue cycle management. This includes, online claim status, expected and estimated cash flow, claims details and eligibility verifications. We follow two significant step of the quality analysis. Before submitting claims to the carrier the claims are scrubbed across the various standardized rules and regulation to verify the accuracy and flag inconsistencies – this is first analysis. And then the claims are again verified manually and this is the second analysis. By following this two-step of quality analysis help us to achieve a greater first pass ratio at first submission.

Regular denial management

Every medical practice experiences claim denials and it is crucial for centers to keep a track of denials. Our daily denial management process ensures claims reconciliation quickly and effectively. Our skilled team we keep complete track of denials and whenever a denial is detected, it is flagged and instantly sent to the accounts receivables team for resolution. Our teams are in constant coordinate with each other until proper denial resolution is achieved. Our stringent processes had resulted in increased cash flows and reduced the accumulation of accounts receivable.

Regular insurance follow-ups

With the main goal to provide maximized revenue, we work through all the phases of the revenue cycle management from insurance eligibility checks to Regular insurance follow-ups. The crucial part is some centers decide one day of the week to work on denials. By this the time, the denials get overflow and it gets tough to recover the balances. Depending on insurance, we regularly track and follow up the denied claims. This provides accurate claims status and predicts revenues for the practice.

Technology infrastructure

Out direct interaction with insurances helps to receive payments quickly and electronically. We constantly keep in touch with carriers and clearing houses and to set up ERA (Electronic Remittance Advice) and EFT (Electronic Fund Transfer) utilities with all possible carriers. The main advantage of this infrastructure is it provides quick payment and detailed revenue projection.

Payment posting and reconciliation

Our skilled team checks payment gateways on a daily basis and if the payment is received, the balances are matched on the same day. Timely reconciliation reports help the clients understand the financials. Pending patient balances are applied and adjusted frequently to avoid accumulation of unapplied payments. Apart for these, we also update and assist centers on payment while reducing of massive paperwork within your practice