Revenue Cycle Management

Revenue Cycle Management

Effective Revenue Cycle Management (RCM) is essential for healthcare providers to maintain financial stability, reduce claim denials, and maximize revenue. Our comprehensive RCM services ensure that healthcare facilities, private practices, and medical professionals optimize their billing processes while staying compliant with industry regulations.

Our Services

We offer a full range of RCM services tailored to meet the needs of healthcare providers. Our expertise spans from patient registration to final payment collection, ensuring a seamless and efficient financial workflow.

1. Patient Registration & Insurance Verification

   1. Accurate patient data entry to prevent claim denials

   2. Verification of insurance eligibility and benefits

   3. Prior authorization management for procedures and treatments

2. Medical Coding & Documentation Review

   1. Skilled medical coders ensure precise ICD-10, CPT, and HCPCS coding

   2. Compliance with HIPAA and payer-specific guidelines

   3. Coding audits to minimize errors and optimize reimbursements

3. Claims Submission & Management

   1. Efficient claim submission with reduced rejections

   2. Real-time tracking and follow-up on claims

   3. Denial management and resubmission of rejected claims

4. Payment Posting & Reconciliation

   1. Accurate posting of insurance and patient payments

   2. Analysis of Explanation of Benefits (EOBs) and remittance advice

   3. Identification and resolution of payment discrepancies

5. Accounts Receivable (A/R) Follow-Up

   1. Proactive tracking of unpaid claims

   2. Appeals for underpaid or denied claims

   3. Continuous follow-up with insurance companies

6. Patient Billing & Collections

   1. Transparent patient statements and billing support

   2. Payment plan setup and collections assistance

   3. Customer service for patient billing inquiries

Skilled-Based Expertise

Our team consists of highly skilled professionals specializing in:

• Certified Medical Coders (CPC, CCS, CRC) with deep knowledge of medical terminology and payer guidelines

• Billing Specialists proficient in claim submission, reimbursement optimization, and denial resolution

• A/R Specialists ensuring efficient follow-up and collections

• RCM Consultants providing data-driven insights to improve revenue cycles

By outsourcing your Revenue Cycle Management to us, you ensure a streamlined, efficient, and compliant financial process, leading to maximum revenue and operational efficiency.