Healthcare Revenue Cycle Management Service
Optimize your returns and shorten your revenue cycle. Schedule a consultation with us for a FREE custom analysis of your practice’s medical billing
Eligibility Checking
Customized Scrubber Checks
Claims Processing
Build Customized
Scrubber Checks
Claim Follow-up to Ensure Payer Acceptance
Posted Updates on Insurance, Patient Payments and Denials
Denials and Appeals Management
Processing Patient Statements
Designated Call Centers to take Patient Calls
Dedicated RCM Client Service
Eligibility Checking
Posted Updates on Insurance, Patient Payments and Denials
Customized Scrubber Checks
Denials and Appeals Management
Claims Processing
Claim Follow-up to Ensure Payer Acceptance
Processing Patient Statements
Build Customized
Scrubber Checks
Designated Call Centers to take Patient Calls
Customized Scrubber Checks
Dedicated RCM Client Service
Unlocking Success with Our Medical Revenue Cycle Management
PrognoCIS RCM combined with PrognoCIS EHR and Payment Collections creates a simple, single source for managing your Revenue Cycle.
Discover the Key Benefits of Medical RCM for Your Practice
There are extensive benefits when practices integrate their EHR System with healthcare Revenue Cycle Management. These include:
Improves Cash Flow
Revenue Cycle Management saves money by increasing the success rate of every claim, reduces the frequency of denied claims, and improving the overall collections.
Time-Saving
Medical RCM Services can help Healthcare Providers save time by streamlining the Financial Process of their Medical Practice helping them to focus more on Patient Care.
Error Free Claims
Focusing on the Front-End Processes, reduces errors made in the beginning which could impact the Claim Processing helps the success rate and increases reimbursements.
Streamline Processes and Boost Revenue: Key Features of Our Medical RCM Service
Real-time eligibility verification is done even before a patient visits the facility. This is a great way to help reduce the risks of rejected or denied claims that can come when a medical practice accepts the information provided by the patient alone.
A clean claim is one that was processed correctly by a Health Facility and reimbursed by the payer on the first submission. When assessing the effectiveness of a Healthcare Revenue Cycle Management, it’s important to determine the percentage of clean claims while uncovering the causes of unsuccessful ones. By monitoring trends, you can identify areas of weakness in the current system moving forward. With PrognoCIS claims are automatically generated saving time and reducing delays. PrognoCIS has a 96% clean claim rate.
Key Performance Indicators (KPI) help physicians and management understand the strengths and weaknesses of their revenue cycle and help guide future decisions. They also help prioritize resources and recognize key success drivers. Here are some of the Key Performance Indicators of successful revenue cycle management for facilities that PrognoCIS implores.
When evaluating revenue cycle management, it’s crucial to consider the gap between the date of service and the date billed. In many cases, filing dates are delayed due to coding errors, incorrect insurance information, or other mistakes on the part of the staff. For example, using an outdated code generally results in a claim being denied automatically. This issue can cost the company money and time in the long run.
Reimbursement Turnaround Time refers to the amount of time it takes from the time the claim is submitted to receive reimbursement. If your facility is filing accurate claims, your turnaround time for reimbursement should be relatively quick. On the other hand, practices that lack effective revenue cycle management may experience significant delays in getting paid.
Claims denials are a fact of life in the healthcare field. However, by adopting efficient revenue cycle management, medical practices can take steps to boost profitability. Some of the numbers to consider include:
- Percentage of denied claims (both overall and by the payer)
- Percentage of denials by category
- Percentage of no-response claims
One of the benefits of effective Medical Revenue Cycle Management is that it allows Health Providers to automate claims filling and support timely filing. By requesting payments as soon as the encounter has been completed, you boost the odds of successfully collecting the debt.
Health Providers often lament the fact that they aren’t collecting larger percentages of their accounts receivable. As a Healthcare Provider, it’s important to determine how much money you’re collecting compared to the amount billed. Additionally, you can divide total accounts receivable by average daily charges to determine the days in AR. Generally, an account receivable of 120 days or more is indicative of problems with your RCM.
Our billing reports help you gauge the expected revenue.
Enhance your Medical RCM with PrognoCIS
Our Medical RCM solutions helps Monitor your Daily Charge, Identify any inconsistencies, and manage your overall Practice Revenue.
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