high level support for high level practices
Enhance your rcm cycle to keep up with industry changes
A poorly managed revenue cycle management process, whether in-house or outsourced, can bring a practice to ruins. These departments and suffer from high employee turn-over, ineffective training programs, and fragmented and inefficient processes; leading to low transparency, staff burn out, and serious financial losses.
Your RCM process starts as soon as your patient makes contact for an appointment and moves through several time expensive steps to ensure a successfully paid claim. Besides the typical internal issues, your RCM team faces challenges from an constantly changing payer requirements, complex regulatory compliance issues, and emerging alternative payment models. These demands on staff take away from patient facing activities that can help to drive higher satisfaction and healthier revenue lines.
focus your practice on patient cycle not revenue cycle
Payer-Provider relationships are rapidly changing, and the pressure is on the provider side to keep up. Our muli-tiered service let’s you pick the level of support that is right for your practice.
- Basic
- Performance Dashboards
- Timely Filing Alerts
- A/R Monitoring
- Payer Updates
- Standard
- Includes Basic
- Staff Development & Training
- Patient Eligibility Management
- Patient Demographics Updates
- Enhanced
- Includes Standard
- Patient Statements
- Patient Estimates
- Pre-certification & Authorization Management
add defensible fee schedule management starting at only $299!
- Premium
- Includes Enhanced
- Full Service RCM
- Charge Posting & Scrubbing
- A/R Management
- Schedule & Chart Reconciliation
- New Service Line Planning
- Payer Audit Management
- Payment Posting
- Transition Planning for Alternate Payment Models
- Credentialing Management Included
what is a good rcm process?
An effective and efficient RCM process is so seamless as to be not noticeable during normal clinic flow. The focus is put on making your encounters ones of healing rather than commerce.
Starting when a patient contacts for an appointment, potential failure points are proactively addressed, allowing for ample correction time. Patient demographics are updated and the insurance is verified as active. Accurate appointment details are obtained and weighed against plan benefits to predict coverage, the patient is provided a reasonable estimte and authorizations or referrals are obtained.
Providers and scribes utlize assistive technologies to accurately code exams, procedures, and testing to an appropriate level of service. Posted charges are scrupulously reveiwed to verify pertinent and accurate information are present, including valid diagnosis codes and applicable modifiers. Timely submissions, within 48 hours, are best handled via EDI transmissions to ensure expedited receipt and processing; combined with e-payments and vigilant A/R management to best manage your days sales outstanding.
Patient statements are generated and sent to patients daily, ensuring timely communications while the patient still remembers the value of the service provided. Pay via web is offered for those patients that prefer not to call or mail payments.
Staff enjoy continous development programs to encourage up-skilling; while continuous improvment methodologies are employed to further increase the quality of work delivered. Performance dashboards are utilized with regular updates to trend information and predict potential failures.
Ben Marcus Consulting 