Increasing customer expectations and growing business complexity have indeed changed the RCM landscape. We are geared to satisfy your current and future business needs, and build your revenues – claim by claim!
Amidst the mounting RCM business challenges, Resilient Revenue understands that success is assured only by meeting your end-customer deliverables and collections. This is often exactly what our systems, processes and technologies are aligned with.
We touch every aspect of the revenue cycle. From appointment scheduling to account closure, our three pillars – people, processes and technology work towards higher reimbursements and accelerated cash flows.
Resilient Revenue can work on your entire revenue cycle business, or on individual processes. Our pricing models are stitched consistent with your business choices. Either way, your benefits are assured.
Revenue cycle management features a significant impact on the way your hospital or practice functions. Rising cost of healthcare combined with strict regulations which keep changing regularly has made daily operations a chore for healthcare providers. A contemporary healthcare provider needs policies and practices in tandem to stay financially secure. With our tailor made revenue cycle solutions, you’ll see an impact on your day-to-day operations while taking advantage of enhanced customer satisfaction along with improved claims submission and enhanced cash flow.
Whether you’re a healthcare provider or a private physician, we will provide services which will meet your exact needs. Our wide selection of healthcare revenue cycle management services includes –
We can assist you to process your patients’ personal, demographic, and every other insurance-related information. At each step of the cycle, we make sure that we verify and validate patient information. During insurance verification, easy identification of insurance mismatch, wrong provider details, etc. can assist you inavoiding losses down the road.
Checking eligibility of the patients is time-consuming because it’s a resource-intensive task. This is often completely taken care of by our trained professionals who will check all medical documents, verify the patient coverage, follow-up with patients if there’s a shortfall within the supporting documents. The ultimate report is going to be filed for faster processing.
Insurance claim denials are a serious pain point for healthcare businesses around the world. We will assist you analyze, correct, and re-submit denied claims. This process includes identifying denials by revenue coding and CPT/HCPCS codes. Once this is often done, the rationale for the denials is analyzed and an in depth denial management report is ready. With this, you can effectively manage claim denials.
Strict regulations and increasing instances of change in CMS guidelines have led to increased risk in medical coding. Our accurate medical coding services can assist you, to create and streamline patient records within a brief period of your time, while accelerating physician payments. Our team is comprised of Certified
Professional Coders (CPCs) accredited by the American Academy of Professional Coders (AAPC). They add accordance with the updated standards and methodologies laid down by CMS, Medicare contractors, AMA, medical societies, and federal organizations.
Charge capture is extremely important since it helps doctors accurately record all the whole information for services provided. This information is then sent to different payors for fast and timely reimbursement. We will process charges for multiple specialties within a brief turnaround. We have extensive experience in handling –
• Medicare
• Third Party Liability
• Medicaid
• Managed Care
• Preferred Provider Organizations
• Indemnity Insurers
• Workers Compensation
We can help you identify patient accounts that need follow-ups and take the requisite action to gather unpaid/underpaid claims. Our services include –
• Accounts receivable analysis
• Identification of the grounds for claims denials
• Follow-up on pending claims
We can also prepare monthly reports which will help you manage your income and increase profitability. These include reports associated with –
• Aging A/R
• Charges, payments, and adjustments
• Payment punctuality for various Payers
• Payer mix
In this way, we offer a variety of revenue cycle management services which will help you work better.
Our services are ideal for healthcare providers who need a 360 outlook of their RCM system, and the way it’s affecting their bottom line. We create custom reports through powerful dashboards which you’ll access from any location and device. Our services contain –
• Charge and Payment reports
• Procedure frequency and diagnosis reports
• Payment reimbursement reports
• Lockbox reconciliation reports
• Payor analysis reports
We ensure fast and accurate posting of all payments from Insurances and Patients, into your Practice Management Software. We also do regular auditing and reconciliation of all posted payments, which helps to scale back errors.
We can manage both electronic claims submissions and submission of paper claims. Our experienced team prepares the explanation of benefits (EOBs) and submits the claims to the insurance payers.
