#rcm cycle

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Revenue Cycle Management (RCM) - The Process and its Benefits

Healthcare Revenue Management (RCM) is the practice of optimizing revenue and expenses that includes collection of patient demographics, cla

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Revene Cycle Management

 Well, the medical billing process refers to a long chain that focuses on gathering data for billing purposes. The process includes the patient, the health care provider and the insurance provider in the billing cycle. These three parties play an important role in information sharing, payment, and reimbursement process.

Important In medical billing is

Revenue Cycle Management (RCM)

Revenue cycle management (RCM) is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.

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Revenue Cycle Service

24/7 Medical Billing Services is here to help you save maximum revenue and get reimbursements for all the rendered services. Our end to end RCM services consist of the following:

Patient Appointments

We help in maintaining a smooth patient influx and operate the clinic in an efficient manner. We fix appointments on time in an organized manner and reduce patient waiting time significantly.

Medical Eligibility Verification

We help you determine the exact amount a patient owes in the form of Copays/Coinsurance/Deductibles. This also helps reveal the patient’s payment history.

Service highlights:

Patient eligibility for coverage

Amount insured for particular diseases and medical services

Traditional & Latest Coding

Our certified coders (CPC, COC, CIC, CPC-P, CPM, CPMA, CPCO, CPC-H, etc.) take care of specific specialties and ICD-10 coding. They assist in documenting appropriate CPT and ICD codes and Modifiers.

We also educate the practice about procedures that can be billed together along with a particular treatment or accompanying medical services. While doing so, we adhere to the coding guidelines.

Demographics / Entry

Our billing experts take care of the demographics and charge entry. They help the medical practice track claims to understand when and where the claims go and keep them informed about the filing of claims within 24 – 48 hours.

Quality Review

Our quality team monitors every process of the RCM cycle. Quality reports and analytics are shared internally with the team on a daily basis and with the client during the review meeting.

Service highlights:

Well-trained staff for providing updates to clients

Multiple levels of cross-checking process

Electronic Claims Submission / Rejections / Resolutions

We maintain a 99% clean claim standard. The trends and analysis are shared with the Coding and Claims entry teams along with the client as per the client’s convenience during the review meeting.

Payment Posting

The payments received through ERA/EOB are posted on the system within 24 – 48 hours and reports are reconciled on a daily basis. Denials are captured and moved to the denial analysis team.

Service highlights:

Two levels of quality audit to ensure the process is at par with international standards

Trained staff that understands patient responsibility too, such as secondary balance, etc.

Denial Analysis & Resolutions

Claim denials are analyzed carefully and the root cause is defined for each problem. It is then escalated to the concerned teams to make sure the denials are fixed and ensure they don’t recur in the future. Denial analysis is shared with the client once a week.

Service highlights:

Deal with denials within 72 hours of receipt

Detect the trend and track the percentage of denials daily

Meticulous system to avoid disruption in revenue inflow

Accounts Receivable Follow-up

We run behind every dollar on the table. When we took over new projects, we collected millions of untapped dollars. We check with insurance companies for outstanding claims over 30 days through AR calling. The trend and details of the report are shared with the practice once a week/month.

Monthly Reporting

We send a monthly report with a detailed financial summary, procedure productivity, collections reports (with the adjustments). We provide details of insurance-wise financials, rejections, denials, and AR reports along with the practice performance report.

Cater to the special requirements of clients and generate customized reports

Monthly Patient Statements

We help you streamline your collections process by sending monthly statements to patients. We appraise the patients on time and regularly help them organize the payable amount.

We also handle patient calls and take payments over the phone

24/7 Support with Dedicated Account Managers

It’s good to be in touch. Our Account Managers are available 24/7 all year round to cater to your needs and concerns. Allow us to help you while you continue spreading cheer and care.