Middle Revenue Cycle Management (RCM)
- Medical Coding (incl. Telehealth)
- Charge Entry
- Claim Submissions (Electronic and Paper)
- Payment Posting
- Clinical Documentation Improvement (CDI)
- QA, Audit
We bring several notable benefits to your organization by well managing your middle revenue cycle.
Accurate Coding and Documentation
Effective middle revenue cycle management ensures accurate coding and documentation of medical services provided. Proper coding leads to correct billing and reimbursement, minimizing claim denials and audits. Accurate documentation also supports improved patient care coordination and communication among healthcare providers.
Increased Revenue Capture
Optimizing charge capture processes helps ensure that all services rendered to patients are appropriately documented and billed. This includes capturing all billable procedures, tests, medications, and supplies. Effective charge capture maximizes revenue by reducing missed charges and improving billing accuracy.
Enhanced Compliance
We make compliance with coding guidelines, regulations, and payer requirements a top priority thus mitigating the risk of fraud, billing errors, and potential legal issues. We ensure adherence to industry standards, such as the International Classification of Diseases (ICD) coding system, the Healthcare Common Procedure Coding System (HCPCS), and Current Procedural Terminology (CPT) codes.
Improved Revenue Integrity
Our well-managed middle revenue cycle model ensures that the billed charges are accurate, complete, and in compliance with payer policies. By conducting regular audits, we can identify and rectify any potential revenue leakage or non-compliance issues, leading to optimal revenue capture.
Streamlined Claims Submission
With proper validation of claim data, ensuring all necessary information is included, and submitting claims within the required timeframe, we ensure an effective and streamlined claims submission process. Our proprietary process minimizes claim rejections and denials, reducing the need for time-consuming rework and resubmission.
Improved Financial Performance
We help improve financial performance by reducing claim denials, accelerating reimbursement timelines, and minimizing revenue leakage. It is a measured goal for us to optimize revenue collection, reduce days in accounts receivable (AR), and maintain a healthy cash flow for your organization.
Data Analytics and Performance Metrics
We provide actionable insights and clean data analysis that allows you to identify trends, patterns, and areas for improvement. It enables informed decision-making, strategic planning, and performance monitoring to optimize revenue cycle operations continually.