End-To-End Revenue Cycle Management Services

Ensure accurate patient insurance coverage and benefits verification to streamline the billing process.

Capture and maintain essential patient demographic information accurately for billing and administrative purposes.

Input and manage charges for medical services rendered to ensure accurate billing and reimbursement.

Assign appropriate medical codes to diagnoses, procedures, and services for accurate billing and compliance with coding regulations.

Submit claims to insurance companies promptly and accurately for timely reimbursement.

Handle rejected claims efficiently by identifying and resolving issues to resubmit claims promptly.

Record and reconcile payments received from insurance companies and patients for accurate accounting and revenue tracking.

Manage outstanding accounts receivable efficiently to ensure timely payment and optimize cash flow.

Address claim denials promptly and effectively to maximize revenue and minimize financial losses.

Manage and reconcile credit balances on patient accounts to ensure compliance with regulatory requirements and accurate financial reporting.

Facilitate provider credentialing and enrollments with insurance companies to ensure participation in payer networks.

Set up electronic data interchange (EDI), electronic funds transfer (EFT), and electronic remittance advice (ERA) enrollments for efficient claims processing and payment handling.

Generate and send patient statements for outstanding balances to facilitate patient payments and account reconciliation.

Analyze revenue cycle data to identify trends, patterns, and areas for improvement, enabling informed decision-making and performance optimization.

Obtaining pre-authorizations or pre-certifications from insurance companies for certain medical procedures or services to ensure coverage and reduce claim denials.

Conducting regular audits and monitoring to ensure compliance with healthcare regulations, coding guidelines, and payer policies to avoid penalties and legal issues.

Managing contracts with insurance companies, including negotiation, renewal, and oversight, to ensure favorable reimbursement rates and terms.

Ensuring the accuracy and completeness of all revenue-related data and processes to prevent revenue leakage and maximize revenue capture.

Providing financial counseling services to patients to help them understand their healthcare costs, insurance coverage, and payment options, ultimately improving collections and patient satisfaction.

Implementing processes for continuous quality assurance and performance improvement to optimize revenue cycle efficiency and effectiveness over time.

In addition to our core RCM services, we go above and beyond to empower our clients with knowledge and expertise. We provide comprehensive education on coding guidelines, payer policies, and state regulations, ensuring our clients stay informed and compliant in an ever-evolving healthcare landscape.