Enabling Enterprise-Level Reconciliation and Audit Controls Across the Entire Revenue Cycle

Posted on October 28, 2024October 28, 2024

In many of today’s Health Systems with multiple Hospitals, Clinics and ASCs, disconnected legacy applications require a significant amount of manual work in order to reconcile all bank deposits being received across all locations. This leads to business office inefficiencies and inaccurate reporting. To tackle this problem in the most efficient way possible, an enterprise solution that can capture and process these payments (of all types) from POS to A/R Collections is required.

ReSolve® Treasury Workstation is an application that works directly with your bank’s Banking Association Institute (BAI) data to create the source record for enterprise-level reconciliation. This includes the use of multiple EHR/EMRs, PM Systems, Banks and Clearinghouses. From payment posting to bank deposits, ReSolve® turns your lockbox payment data into an exception-centric workflow that automates the matching and reconciliation of all posted and distributed remittances back to their associated lockbox deposits.

Improving Data Accuracy and Productivity with Automated Workflow

Utilizing RPA and AI technology, we replace manual, error-prone tasks with automated workflow processes that lead to permanent revenue cycle improvements. We start by ensuring that remittances are not applied to the billing system until corresponding funds have been deposited to your bank account, and end with the integration of payment transactions that have been distributed and processed in each of the billing system(s) of record. This includes the capturing, tracking and reporting of all unidentified, unmatched and posted transactions.

Automated Exception Worklists for Outstanding Issues

With RCMS and ReSolve®, all exceptions can be tracked using a variety of search options, including Batch Number; Patient Name; Check Number; Payment Amount; and Payor. Once the transaction has been identified and the problem is repaired, the funds become eligible for transfer or posting with all money being accounted for back to the bank deposits.

ReSolve® Treasury Workstation Benefits:

Enables tighter audit controls across your entire revenue cycle by integrating disparate systems into a single cash management solution across the enterprise
Ensure that remittances are not applied to the billing system(s) until corresponding funds have been deposited into the bank account
Streamlines and automates processes for enhanced workflows and productivity
Improves ERA/EOB throughput with automated check matching to bank deposits
Automatically tracks and reconciles adjudicated transactions for automated reconciliation of all matched funds
Provides true exception-based process handling by reviewing only the transactions requiring user-controlled follow-up activities
Customizable user-interface seamlessly ties together your bank deposits, RCMS ReSolve® A/R Management Platform and all host billing EHR/EMR & PM systems
Eliminates duplicate data-entry and the need for third-party spreadsheets
Can capture and split non-provider payments, such as parking garage and gift shop transactions.
Facilitates banking and clearinghouse partner diversification to minimize risk
Integration to the GL system provides end-to-end automation of the bank/treasury workflow

Working with RCMS

With our Treasury Workstation and automated Exception Worklists, clients can quickly review payment discrepancies to determine and correct outstanding issues in a timely manner. Contact RCMS today about improving revenue cycle efficiency with enterprise-level reconciliation.

Leveraging the Benefits of ECM with Your Revenue Cycle Management Objectives

Posted on October 2, 2024October 3, 2024

When it comes to getting work done better and faster, having quick access to all of the information you need is paramount to making that happen. Enterprise Content Management (ECM) is about organizing digital assets and automating document-driven processes. For Health Systems and IDNs facing increased demands on staff, integrating ECM technology with their Revenue Cycle Management (RCM) processes can provide a significant increase in business office efficiency. With the RCMS ReSolve® A/R Management Platform, custom programming leverages ECM technology by creating a series of automated workflows, saving considerable hours in getting work accomplished.

Automated Document Capture, Indexing and Routing for Increased Productivity

Utilizing rules-based workflows, RCMS provides for the automated routing of all correspondence documents, images and other electronic files to be worked much faster, reducing turn-times and increasing productivity. The key is to have a scalable, enterprise solution, such as Hyland Software’s OnBase® ECM Platform, which is capable of managing any type of document format. Using advanced sorting technology, such as auto-indexing and classification, files can then be attached to worklists that are automatically updated for the appropriate department or revenue cycle team designated for specific tasks.

System-Generated Work Assignments for Improving A/R

For Customer Service and Accounts Receivable (A/R) Departments, it’s important to resolve a customer dispute or to collect on overdue payments as earlier as possible. RCMS can help to improve first-call resolutions by providing immediate access to all of the patient’s relevant documents, authorizations, and orders. Our ReSolve® platform provides an ‘Account Inquiry’ tracking tool used for efficiently capturing all payment activities and denials. System generated work queues identify those accounts requiring proactive follow up and assigns them to a specific department, team or individual.

Enhancing Your Host Billing System

With RCMS and ReSolve®, we can improve key areas of need in your business office — for users of all major EHR/EMR and PM platforms. With our ‘bolt-on’ technology enhancing and integrating to your current ‘host billing’ system(s), financial performance objectives can be systematically targeted and achieved. Visit our Systems Integration page for further details.

Contact RCMS today about improving revenue cycle processes in your business office.

OnBase® is a registered trademark Hyland Software, Inc.

Reducing Denials with Integration, Automation, ECM and Analytics

Posted on April 11, 2024May 13, 2024

Minimizing Payment Delays with Synchronized Activity Across Multiple Applications

RCMS works to improve a wide range of revenue cycle areas where changes to manual work processes and the use of workflow automation technology can have a significant impact on the financial performance of healthcare provider organizations. Our ReSolve® Denial/Defect Management enables simultaneous access to both billing and ECM document imaging systems — a key step for creating efficient workflow. It first queries eligibility and authorization files to determine a course of action, then routes the denials to appropriate work queues. ReSolve® then facilitates decisive activities with predesigned correspondence and tracking capabilities, from generating appeals through rebilling and payment.

An optional component of the ReSolve® A/R Management Platform, the Denial/Defect Management module can track follow-up pursuits by user, KPIs and work queue, enhancing departmental oversight and staff performance.

In addition to providing configurable worklists for more efficient and organized user activity, ReSolve® can also synchronize denial and appeal actions to multiple EMR/EHR billing applications and/or Practice Management systems. This is extremely beneficial to Central Billing Offices (CBOs) having to reconcile and post payments for multiple systems.

Creating Permanent Revenue Cycle Improvements

Our ‘connected systems’ approach unlocks the potential of extensive data generated as a result of revenue cycle processes. Integrated with Hyland Software’s OnBase Enterprise Content Management (ECM) solution, the ReSolve® Platform combines the advantages of ECM with systems integration and automated workflow. With this capability, RCMS clients have access to automated reports, drill-down data analytics, pivot charts and customized scorecards — where denial trends can be analyzed and traced to specific areas, from patient access and eligibility to individual physicians and departments. By identifying the root cause of denials and taking corrective actions, the initial denial rate of future claims is therefore reduced.

Working with RCMS

With enhanced productivity through improved data collection and automated workflow processes, our ReSolve® applications can work across your entire revenue cycle for a tightly integrated solution. Contact RCMS to discuss all of your remittance processing, data validation, treasury reconciliation and denial management objectives.

Maintaining A/R Management Processes In Migrating to a New System

Posted on July 10, 2023August 13, 2024

Depending on the EMR systems and other purpose-built applications being used, a “rip and replace” migration strategy that dramatically changes A/R management and financial reporting processes can significantly affect revenue and collection cycles essential to a steady cash flow.

RCMS’ proprietary technology and systems integration experience allow us to specialize in the capture and conversion of all data types from disconnected information silos. By utilizing our ReSolve^® A/R Management Platform that is designed to be a system agnostic front-end solution, we can leverage the most current RPA and AI technologies to optimize all the revenue cycle information being generated or received.

By integrating with the host billing systems, practice management systems, enterprise content management (ECM), and other line of business (LOB) applications, RCMS can improve data accuracy and automate workflows to significantly enhance your cash management and revenue cycle processes. This also provides for a more strategic and successful migration – with minimal disruption to cash flow.

Please visit our Systems Integration page for additional information.

Keys to Maintaining A/R Processes

Integration with host billing systems
Use best available capture solutions
Same day processing of today’s receipts
Capture all adjudication data
Automate separation of remittance data
Use data validation rules to cleanse, scrub and normalize payment data
Provide reconciliation from bank deposit through billing system to general ledger (GL)
Performance monitoring metrics by payor/user

Working with RCMS

At RCMS, we are experienced in working with most every major EHR/EMR, Clearinghouse and PM system. We utilize Artificial Intelligence (AI) and Robotics Process Automation (RBA) in order to enhance and automate workflow for a wide variety of medical claims and billing processes. Our solutions, featuring the ReSolve® A/R Management Platform, provide business process improvements in all areas of the revenue cycle. Contact RCMS about helping to develop a systems migration strategy for your organization.