Standard Revenue Cycle Management Services
Revenue Cycle Assessment
RCM Performance Assessment and Benchmarking
Medical Billing
- Insurance Eligibility Verification
- EDI Enrollments (Clearinghouse)
- ACH and EFT Payor Enrollments
- Charge Entry/Charge Collection – Surgery and Clinic
- Manage Payment Posting activities (EFT’s and Checks)
Denial Management
- Medical Record Requests
- Claim Denial Management and Resolution
AR Management
- Insurance and Patient A/R Follow up
- Self-Pay Analysis & Patient Statements management
- Appeals and Claims Negotiations
EMR Optimization
- EMR Collector Module
- EMR Clinical Module
- EMR Communication Module
Comprehensive RCM Services
Payor Enrollments
- Providers and all Midlevel Payor Enrollments
- Payor portal access management
Provider Credentials
- Medical Licensure and Renewals
- Hospital Privileges and Renewals
- CAQH Maintenance
EMR Management
- EMR monitoring and management: Attend and manage partnership meetings
and monthly meetings with CSM - Assist with EMR Contract Renewals
Surgery
- Pre-Authorizations – Path to approval authorization workflow prior to
surgery or intraoperative add-ons - Surgery Financial Clearance process
RCM Performance monitoring
- Revenue Cycle Performance Dashboard
Compliance/Contract compliance
- E/M audits / Annual Audits
- Surgery/Procedure claim audit
- Underpayment variance projects
- Contract negotiations
- Annual Provider education
Medicare Value Based Care
- Assist with billing for MIPS/MVPS
- Preparation for MIPS/MVPS
**Comprehensive RCM services Includes Standard RCM Package.