The key to managing RCM successfully is no different from any other process. They stand on the three pillars of people, process and technology. This belief is reflected in our approach of bringing together the best industry talent and enabling them with time tested methodology and state of the art technology tools.
Revenue Cycle Management
We offer our capabilities across the RCM value chain to provide sustainable solutions that positively impact your business. Be it reducing your DNFB (Discharged Not Final Billed) or the days in AR, to improving reimbursement through CDI initiatives, our team’s endeavor is to deliver an improved business outcome and not merely adhere to a process. We take pride in our ability to serve our hospitals and provider groups from the point of scheduling and registering a patient and supporting them right through the cycle, with medical coding, claims submission, AR / Denial Management, payment posting and finally closing the loop with secondary insurance / patient billing as applicable.
It is proven well beyond doubt that the answers to plugging downstream claims denials are most often found in upstream patient access functions – scheduling, eligibility verification, pre-authorization and registration. We offer a comprehensive suite of capabilities across this entire value chain.
Billing, Claims Submission and Clearing house rejections processing
First pass rate in claims submissions is an important metric that our team tracks very closely. They’re continuously investigating causes of claims fallout at the scrubber and this insight is looped back to the patient access team to avoid the errors in future and hence, continuously improving the metric. Automated eligibility verification and root cause analysis of clearing house rejections are examples of how we look for ways to improve operational efficiency and accelerate receivables reductions.
Payment posting and correspondence processing
While transactional in nature, this function has direct P&L implication and compliance fallouts. Electronic remittances lend themselves to automation and are ideal places to start one’s journey in the automation roadmap. An innocuous piece of paper received in correspondence has the potential to trigger a regulatory compliance fallout, if not processed promptly and correctly.
Accounts Receivable and Denials Management
The workflow design that enforces prompt follow up at designated timeframes, the right action to be taken in each claim scenario, the reporting capability to analyze the denials for fixing upstream process gap and many more such nuances distinguish our team. Ensuring that every claim gets paid is a job only partly done. Our team extends the responsibility well beyond that and looks for reasons why a claim was held up in the first place and how can we help accelerate the process to ensure reduced denials and faster claim resolution.