Efficient RCM ensures that
healthcare providers are paid promptly
and correctly for the services they deliver.
- +440-98-5298
- info@example.com
- 121 King Street, Melbourne
The benefits of RCM include
Overall, RCM is vital for the financial health of healthcare practices, ensuring they get compensated for their services while maintaining efficient and patient-friendly operations.
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Improved Cash Flow
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Reduced ErrorsRCM processes help in minimizing billing and coding errors, leading to fewer rejected or denied claims.
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Compliance and AccuracyMaintaining compliance with healthcare laws and regulations is easier with RCM, as it involves accurate coding and billing practices.
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Time and Resource SavingsRCM frees up healthcare providers and staff to focus more on patient care rather than financial and administrative tasks.
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Enhanced Patient SatisfactionStreamlining billing and payment processes can lead to a better patient experience, as it makes financial interactions smoother and more transparent.
HOW OUR END TO END RCM SERVICE WORKS
Credentialing
Qualification verification, Application to insurance networks, Privileging, Record maintenance, and recredentialing to ensure HCP participation in insurance networks.
Pre-Registration
Collecting Appointment Confirmation & collecting patient information before they arrive, including insurance details, to streamline the subsequent steps.
Registration
Confirming the collected patient information at the time of service and completing any missing details.
Insurance Eligibility and Benefits Verification
Checking the patient's insurance status and understanding the coverage to inform the patient of their liabilities such as Co insurance, Copay, Deductible & Any possible non-covered services.
Compliance and Quality Assurance
Ensuring that all RCM activities comply with healthcare laws, regulations, and standards to avoid penalties and improve service quality.
Coding
Assigning standardized codes to diagnoses, treatments, and procedures according to the ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) systems.
Claim Preparation and Submission
Compiling the billable charges into a claim and submitting it to the insurance company.
Patient Financial Responsibility Estimation
Calculating the patient's share of the service costs not covered by insurance.
Claim Management
Keeping track of the claim after it has been submitted to ensure it is processed.
Denial Management
Addressing any denied claims by correcting errors or providing additional information and resubmitting them.
Collections:
Working on collecting unpaid patient balances after insurance claims have been settled.
Payment Posting
Recording payments received from payers and patients into the RCM system.
Reporting and Analytics
Using data from the RCM process for reporting purposes and to analyze the practice's financial performance for decision-making.
MIPS
Prepare MIPS data for submission to avoid 9% payment adjustment range.
MRA
Certified Coder Analyze SOAP/H&P notes and provide additional data to Provider to maximize their revenue.
Accounts Receivable (AR) Follow-up
Pursuing unpaid claims and patient balances.
Charge Capture
Recording services rendered into billable charges.