REVENUE CYCLE MANAGEMENT (RCM)

REVENUE CYCLE MANAGEMENT (RCM)

 

RCM encompasses everything from determining patient insurance eligibility, property coding/managing claims, payments and revenue generation all with the focus to increase net revenue while maintaining high levels of patient care.

 

Our solution integrates seamlessly with your EHR, synchronizing your clinical and financial operations and leveraging their combined power to maximize your revenue performance while improving your delivery of care.  Features include:

• Electronic claims submission

• Reimbursement accounting

• Denials management

• Patient invoicing

• Patient collections

• Detailed billing reports

• Physician contracting and credentialing

• And much, much more…

 

 

PRE-AUTHORIZATION SERVICES (PRE-CERT PLUS)

 

The prior authorization process can cause more frustration among physicians than any other administrative process.  It is an expensive and monotonous distraction that takes time away from caring for patients.  OPTIMIZING SOLUTIONS Pre-Cert Services, or “pre-authorization services” facilitates the pre-certification process between healthcare providers and their payers.  They are usually required for inpatient surgery, outpatient surgery, hospital admissions, sleep studies, radiology or any procedure that requires a Pre-Certification.

 

Features and benefits include:

 

• Can be used for any procedure that requires insurance pre-certification

• One screen management

• Tracks and catalogs requests based on status

• Validates address, reducing rejections

• Procedure code lookup tool

• Email notifications of pre-cert completions and/or status updates

• Streamlined process saves time and money

• Free up your in-house resources

• Rapid turnaround time and increased customer satisfaction