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Revenue Cycle Management Service

Outsource Revenue Cycle Management Services

Optimize your revenue cycle effortlessly with our comprehensive Revenue Cycle Management Services. Benefit from accelerated staffing, faster turnaround times, impeccable accuracy, and 100% HIPAA compliance.

Our RCM solutions integrate seamlessly with advanced practice management systems, effortlessly bridging the gap between front-end patient interactions and back-end revenue collection. Leveraging our skilled team of AAPC-certified coders, we ensure meticulous charge capture, accurate procedure and diagnosis coding based on ICD-10, CPT, and HCPCS standards, and efficient claims submission. We go beyond mere compliance, focusing on denial management to optimize your revenue stream. Our team conducts thorough pre-claim analysis to minimize denials and employs rigorous follow-up processes on denied claims. We also provide comprehensive accounts receivable management, ensuring prompt payment posting and reconciliation. Our service scope extends from patient registration to final payment, ensuring a seamless, end-to-end revenue cycle.

Our adherence to Six Sigma methodologies in process management significantly reduces errors, thereby enhancing claim acceptance rates. We also deploy AI-driven predictive analytics to anticipate and manage claim denials proactively, further improving your bottom line. Moreover, our RCM services extend to patient access management, ensuring accurate patient registration, eligibility verification, and authorization, thereby reducing front-end denials and enhancing patient satisfaction. In the era of value-based care, our solutions align perfectly with MACRA/MIPS requirements, assisting you in meeting quality reporting criteria while maximizing reimbursements.

Our robust approach, coupled with the latest technology and compliance measures, ensures your healthcare organization stays profitable, efficient, and primed for growth. Let's embark on this journey of operational excellence together. Contact us today for a comprehensive consultation.

Customer Success Stories

Case Study on Eligibility Verification Process

Helped A Leading Third-Party Administrator for Medical Billing Streamline Their Eligibility Verification Process

Our tailored eligibility & benefit verification services addressed the drop in ROI for a leading third-party administrator by resolving unsystematic processes, ensuring accurate insurance coverage for home and lab sleep tests, and meeting deadlines with precision.

Read more
O2I Provided Accounts Receivable Services

Provided Pharmacy Insurance & Medical Insurance Eligibility Services to A US-based Telemedicine Provider

Our efficient eligibility verification services and streamlined communication resolved challenges for a birth control telemedicine provider, ensuring timely prescription transfers, accurate insurance checks, and improved medication delivery.

Read more

Testimonials

Clients Speak

I want to thank you both for the great job you are doing. I could not be happier with my decision to work with you. I am looking forward to our continued relationship and growth.

Owner, Medical Billing,
Medical Billing Services Company, California, USA

Healthcare Revenue Cycle Management Services We Offer

As an experienced revenue cycle management service provider, we offer a range of specialized solutions designed to optimize your revenue cycle, improve cash flow, and enhance the patient experience -

  • Medical Claims Processing Services

    Medical Claims Processing Services

    Streamline your claims submission process with our expertise in handling medical claims. Our team ensures accurate coding, timely submission, and efficient follow-up to maximize reimbursement.

  • Accounts Receivable Services

    Accounts Receivable Services

    Effectively manage your accounts receivable with our dedicated team. We handle claim denials, appeals, and collections, reducing your outstanding balances and improving your revenue cycle performance.

  • Insurance Eligibility Verification Services

    Insurance Eligibility Verification Services

    Avoid claim rejections and payment delays by verifying insurance eligibility upfront. Our team verifies coverage details, co-pays, and deductibles, ensuring accurate billing and faster reimbursement.

  • Denial Management Services

    Denial Management Services

    Minimize claim denials and optimize revenue recovery with our denial management services. We analyze denial trends, appeal on your behalf, and implement strategies to prevent future denials.

  • Accounts Receivable Conversion Services

    Accounts Receivable Conversion Services

    Seamlessly convert your paper-based accounts receivable to electronic formats for improved efficiency and accuracy. Our team ensures a smooth transition and enhanced revenue cycle performance.

  • Payment Posting Services

    Payment Posting Services

    Streamline your payment posting process with our expertise. We accurately post payments, adjustments, and rejections, providing real-time visibility into your financial transactions.

  • Healthcare Payer Services

    Healthcare Payer Services

    Partner with us to streamline your interactions with healthcare payers. We handle payer communications, contract management, and negotiation, ensuring optimized reimbursement rates.

  • Healthcare Collection Services

    Healthcare Collection Services

    Improve your collection rates and reduce bad debt with our healthcare collection services. Our team employs effective strategies to recover outstanding balances while maintaining patient satisfaction.

  • Dental Revenue Cycle Management Services

    Dental Revenue Cycle Management Services

    Experience specialized revenue cycle management tailored to the unique needs of dental practices. We optimize dental billing, coding, and collections, improving cash flow and practice profitability.

  • Accounts Receivable Follow-up Services

    Accounts Receivable Follow-up Services

    Enhance your revenue cycle performance with our diligent accounts receivable follow-up services. We proactively pursue unpaid claims, resolve outstanding issues, and accelerate payment.

  • Patient Experience Services

    Patient Experience Services

    Elevate the patient experience by streamlining your billing and financial interactions. Our solutions focus on transparency, clear communication, and convenient payment options, enhancing patient satisfaction and loyalty.

  • Revenue Cycle Analytics Services

    Revenue Cycle Analytics Services

    Gain valuable insights into your revenue cycle performance with our advanced analytics solutions. We provide comprehensive reports, key performance indicators, and actionable recommendations to optimize your financial outcomes.

Process Flow for Our RCM Services

Our streamlined Revenue Cycle Management process maximizes efficiency, accelerates reimbursements, and ensures optimal financial performance. We have a comprehensive approach that covers every step of the revenue cycle, from patient pre-authorization to denial management, delivering seamless operations and improved revenue outcomes for your healthcare organization -

 

01. Patient Pre-authorization

Obtain pre-authorization from insurance providers to ensure coverage for planned medical services, minimizing claim rejections and delays.

 

02. Insurance Eligibility and Verification

Verify patient insurance eligibility, coverage details, and benefits to ensure accurate billing and prevent claim denials.

 

03. Insurance Claims Submission

Prepare and submit accurate and complete insurance claims to payers for reimbursement, ensuring timely and accurate payment.

 

04. Payment Posting

Post payments, adjustments, and rejections received from insurance companies, providing real-time visibility into financial transactions and maintaining accurate accounts receivable records.

 

05. Denial Management/h3>

Proactively identify and address claim denials, appealing on your behalf, and implementing strategies to prevent future denials. Maximize revenue recovery and minimize financial losses.

 

06. Reporting

Generate comprehensive reports and analytics on revenue cycle performance, including key performance indicators, trends, and actionable insights. Gain visibility into financial outcomes and make informed decisions to optimize revenue management.

RCM Services Software We Use

NextGen Healthcare Kareo Billing & EHR eClinicalWorks AdvancedMD brightree medisoft Athenahealth MediTouch athenahealth Billing & EHR AdvancedMd Billing Epic Billing AdvantX Billing CareCloud Billing Centricity Lytec Billing Misys Modernizing Medicine Billing & EHR Nex-tech Billing & EHR Proclaim Pulse SequelMed TotalMD Billing

The Tactical Benefits of RCM Services for Medical Billing Companies

Elevate your service offerings with our tactical RCM solutions, empowering medical billing companies to surpass industry benchmarks through enhanced claim accuracy, expedited collections, and minimized denial rates. Our strategic approach to RCM equips billing firms with the tools to drive revenue growth and operational efficiency, solidifying their competitive edge in a dynamic healthcare marketplace.

  • Beyond Standard Eligibility

    Elevate your pre-care financial engagement by leveraging our eligibility services that delve deep into patient insurance benefits, securing revenue integrity from the outset.

  • Coding Assistance

    Benefit from our precision-driven coding assistance, which aligns with the latest medical coding updates and compliance regulations, ensuring your claims withstand scrutiny and minimize denials.

  • End-to-End Collections

    Experience the efficiency of our end-to-end collections approach, which combines relentless follow-up with patient-centric communication strategies to maximize cash flow and patient satisfaction.

  • Claim Status

    Stay ahead with our advanced claim tracking, delivering instantaneous updates that empower you to address discrepancies promptly and keep your revenue stream fluid.

  • Custom Reporting

    Transform data into strategy with our custom reporting capabilities, offering you a clear view of operational dynamics and financial performance, facilitating strategic planning and continuous improvement.

Why Choose Us as Your Revenue Cycle Management Company?

Our revenue cycle management solutions are designed exclusively for companies in the healthcare sector and revenue cycle management firms. Our expertise in navigating the complexities of healthcare revenue cycles enables us to provide accurate and timely solutions that drive tangible results. By choosing our services, you gain access to a range of benefits that optimize your operations, reduce costs, and position your organization for sustainable growth -

  • Lower Overheads and Infrastructure Requirements

    By outsourcing your revenue cycle management to us, you can significantly reduce overhead costs associated with staffing, training, and maintaining infrastructure, freeing up resources to invest in other critical areas of your business.

  • High Quality of Services

    Our team of experienced professionals ensures exceptional quality in every aspect of revenue cycle management, from claims processing to denial management.

  • Familiarity with Various Practice Management Systems

    Our team is well-versed in working with different practice management systems, ensuring seamless integration and improved efficiency and accuracy in your revenue cycle processes.

  • Prompt and Timely Service Delivery

    Our average TAT is 24 hours or less and we prioritize prompt service delivery. You can rely on us for timely responses, quick claims processing, and efficient resolution of any revenue cycle issues.

  • High Accuracy and Successful Claims Processing

    Our commitment to quality is reflected in our track record of achieving 99%+ quality and 98% claims getting paid in the first pass. Experience high accuracy and successful claims processing, leading to improved cash flow and revenue.

  • 100% HIPAA Compliant Processes

    Rest assured that our revenue cycle management processes adhere to stringent HIPAA regulations, ensuring the confidentiality and security of patient data throughout the entire cycle.

  • Data Security

    Our commitment to data protection is validated by our top data security certifications, including ISO 27001 and SOC2. We prioritize the security of your sensitive information.

  • Flexibility to Meet Fluctuating Volumes

    Our ability to scale up resources and provide short-term staffing and overtime allows us to adapt to your fluctuating volumes seamlessly. Benefit from the flexibility to handle increased workloads efficiently.

  • Flexible Pricing

    We offer flexible pricing options tailored to your specific needs. We understand that every healthcare organization is unique, and we work closely with you to create a pricing structure that aligns with your budget and goals, ensuring cost-effectiveness and maximizing the value of our services.

Additional Services You Can Benefit From

Medical Transcription Services

We provide HIPAA-compliant transcription solutions to healthcare entities worldwide.

Medical Billing Services

If you are looking for reliable and accurate medical billing support for your company, we have got you covered. We provide coding services you can count on.

Medical Coding Services

Our medical coding solutions are delivered by seasoned medical professionals with a firm grasp of all the relevant codes.

Pharmacy Business Services

Our pharmacy business support services are delivered by seasoned hands with full focus on helping your business grow.

Healthcare Claims Adjudication Services

We have significant expertise and experience in handling all types of medical claims. With us, all claims will be processed and payments received.

EMR Services

We can remotely handle your EHR and EMR records so that they can be relied upon to make informed decisions.

Telehealth Services

If you are looking for world-class telehealth services, you are in the right place. We use the latest technologies to make healthcare accessible to all.

Medical Animation Services

We have been creating medical animations for over 18 years for a global clientele. Our seasoned animators can be relied upon to deliver any type of animation.

Outsource Revenue Cycle Management Services to Us

Entrust your RCM needs to our adept professionals and experience a seamless fusion of precision billing, compliance rigor, and enhanced revenue retention. Our services are meticulously crafted to navigate the intricacies of medical billing, ensuring that each claim is accurately processed and swiftly paid. We deploy innovative technology and industry-leading practices to manage your entire revenue cycle, reducing administrative burdens and allowing you to focus on delivering quality healthcare.

Our partnership provides not only operational efficiency but also strategic foresight. We analyze trends, forecast potential disruptions, and implement proactive measures to keep your finances robust and resilient. With our vigilant monitoring and adaptive strategies, we safeguard your revenue against the ever-changing landscape of healthcare regulations and payer policies.

Elevate your RCM strategy with us-where expertise meets innovation to drive your success. Reach out now to redefine excellence in revenue cycle management.

Contact Us

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Have specific requirements? Email us at: Info Email

Email Us Info Email
Flatworld Solutions Address

USA

116 Village Blvd, Suite 200,
Princeton, NJ 08540

Our Customers

  • Movement Mortgage
  • Alcon
  • ARI
  • Maximus
  • Redwood E-Learning Systems

Frequently Asked Questions (FAQs)

What are the perks of delegating RCM tasks to an external provider?

Delegating RCM tasks to an external provider presents healthcare practitioners with the opportunity to diminish administrative expenditures, amplify the rate of successful claims through expert intervention, and consolidate operational workflows. This delegation enables practitioners to pivot their attention towards clinical excellence while relying on specialized RCM vendors to adeptly manage fiscal responsibilities and regulatory adherence, thereby enhancing the organization's economic vitality.

What should be considered when selecting a legitimate RCM service provider?

When selecting a legitimate RCM service provider, it's crucial to scrutinize their track record in regulatory adherence, such as compliance with HIPAA mandates, as well as their possession of industry accreditations like ISO 27001 and SOC2. Evaluation should also include their technological adeptness, domain-specific expertise, key performance indicators like claim resolution and processing times, alongside references from existing clientele.

Does your RCM offering include full-spectrum support?

Our RCM offering encompasses full-spectrum support, addressing every stage of the revenue cycle from patient entry, meticulous charge capture, and precise claim lodging to reconciliation of payments, managing denials, and diligent accounts receivable tracking, thus ensuring a comprehensive and streamlined fiscal administration.

What kind of technologies are utilized within your RCM offerings?

Within our RCM offerings, we deploy a gamut of sophisticated technologies, including integration with EHR systems, advanced billing platforms, coding software, and the utilization of AI for predictive analytics and automation in denial management, all aimed at enhancing the efficiency of the revenue cycle.

What is the pricing model for your RCM offerings?

Our RCM offerings are competitively priced to ensure a tangible return on investment, adhering to a contingency-based model proportionate to revenue collections or a transaction-based fee structure. Our pricing is designed to be adaptable, meeting the diverse requirements and scales of healthcare organizations.

What timeframe is expected for integrating your RCM services into a healthcare practice?

The timeframe for integrating our RCM services into a healthcare practice is conscientiously planned to minimize interruption, typically spanning several weeks to a few months, contingent on the intricacy of the incumbent system, the breadth of services enlisted, and the degree of customization necessary for a flawless transition.

Do your RCM services incorporate tools that support mobility and patient interaction?

Our RCM services incorporate an array of tools that bolster mobility and patient interaction, including accessible patient portals, mobile-responsive billing applications, and interactive communication systems, all aimed at augmenting the patient's involvement and contentment with the financial aspects of their healthcare experience.