RCM SERVICES

Patient Registration and Eligibility Verification

Accurate Data Collection: Ensure accurate collection of patient information at the point of registration to minimize errors and delays.
Eligibility Verification: Verify patient insurance coverage and benefits before services are rendered to prevent claim denials and payment delays.
Pre-Authorization: Obtain necessary pre-authorizations for procedures and treatments to ensure compliance with insurance requirements.

Medical Coding and Billing

Professional Coding: Utilize certified medical coders to accurately code diagnoses, procedures, and services according to the latest industry standards.
Efficient Billing: Submit clean claims promptly to minimize denials and accelerate reimbursement.
Charge Capture: Ensure all services provided are accurately captured and billed, maximizing revenue and reducing leakage.

Claims Management

Claims Submission: Manage the submission of electronic and paper claims to payers, ensuring adherence to payer guidelines.
Denial Management: Identify and address claim denials quickly to reduce rework and lost revenue.
Appeals Processing: Handle appeals for denied or underpaid claims to recover the maximum reimbursement possible.

Payment Posting and Reconciliation

Accurate Payment Posting: Post payments from insurers and patients accurately and promptly to maintain up-to-date financial records.
EOB Review: Review Explanation of Benefits (EOB) statements to ensure payments match the expected amounts and identify discrepancies.
Account Reconciliation: Regularly reconcile accounts to ensure all payments are accounted for and discrepancies are addressed.

Patient Collections and Customer Service

Patient Statements: Generate and send clear, accurate patient statements to facilitate timely payments.
Collections Management: Implement effective patient collection strategies to reduce outstanding balances and improve cash flow.
Customer Support: Provide excellent customer service to address patient billing inquiries and resolve issues promptly.

Financial Reporting and Analysis

Revenue Cycle Analytics: Provide detailed analytics and reports to track key performance indicators (KPIs) and identify areas for improvement.
Financial Insights: Offer insights into your practice’s financial health, including trends in revenue, denials, and collections.
Performance Optimization: Recommend strategies to optimize revenue cycle performance and enhance overall financial efficiency.