Services For RCM :
Revenue Cycle Management (RCM) team can manage all aspects of provider billing. From claim submission to denial management, our healthcare RCM services experts know how important a healthy revenue cycle is to your practice. Our team can also assist with payer credentialing and enrollment .
Revenue cycle Management Services :
We partner with healthcare organizations to improve and accelerate reimbursements, prevent denials, arrest revenue leakage, and improve the patient experience .
We apply disruptive automation technologies to deliver revenue cycle excellence. Ensure better results with Access Healthcare’s best practices .
We help you get your revenue cycle back on track, reducing costs and driving revenue. Below is an outline of the RCM disciplines We provide services in.
Patient Registration
Improve Patient Registration Quality and Reduce Claim Denials.
Components of our Patient Registration Process
We capture the following information
Patient Demographic Details
* Name, gender, address, phone numbers
* Social security number
Insurance information
*Name of the insurance company, insured person, address on file, ad policy information
* Medicare/Medicaid cards
Payment information
*Name, address, and phone of the individual responsible for payments
Care Details
*Special requirements and assistance needed
Components of our Patient Registration Process
We understand the business of revenue cycle and our team members are experiencedin Patient Registration processes. With Clarus RCM, you get:
Improved turnaround time (24-48 hours), productivity, and accuracy
Reduction in claim denials
Daily account support calls to address any issues
Improved clean claim submission
Reduce costs by as much as 50% through offshore delivery
Authorization:
End-to-End Management of Electronic Prior Authorizations:
As Prior Authorization volumes continue to rise, and as specialty drugs create additional clinical complexities, Health Plans, Pharmacy Benefit Managers (PBMs) and Third-Party Administrators (TPAs) are challenged to adapt while maintaining or improving operational and clinical efficiencies. PAHub, is a HITRUST certified solution that puts the tools at your fingertips to streamline and control all clinical, compliance and administrative aspects of Prior Authorization at the point-of-care to improve compliance, reduce turn-around times and costs. By leveraging the latest technologies for data mining, data analytics, content
management and advanced decision support trees, PAHub, enables customers to automate the end-to-end prior authorization process.
AR & Claims Follow up
One way our team improves efficiency and lowers healthcare administrative costs is by monitoring accounts receivable, also known as A/R follow up. With the variety and ever-changing services that physicians, hospitals and long-term health clinics provide, each patient that is seen will owe a specific amount to the provider based on the treatment that was given. Keeping those payments organized is essential for proper medical billing. A/R follow up ensures that healthcare organizations have a way to recover overdue payer or patient payments. Most A/R follow up responsibilities include looking after denied claims, exploring partial payments and reopening claims to receive maximum reimbursement from the insurance companies.
Denial Management
What is Denial Management Services
Denial management is often confused with Rejection Management. Rejected Claims are claims that have not made it to the payer’s adjudication system on account of errors. The billers must correct and resubmit these claims. Denied Claims, on the other hand, are claims that a payer has adjudicated and denied the payment.
Medical Billing Wholesalers' denial management team has seasoned professionals who:
Investigate the reason for every denied claim
Focus on resolving the issue
Resubmit the request to the insurance company
File appeals where required
We understand that each denial case is unique. We correct invalid or incorrect medical codes, provide supporting clinical documentation, appeal any prior authorization denials, understand any genuine denial cases to pass the responsibility to patients, and follow-up effectively. We re-validate all clinical information before re-submission.
As an extended billing office, we work with you to analyze your denied claims and reduce denial % over time.