Category Archives: Correspondence Management

Comprehensive Approach to Denials and A/R

Taking a Comprehensive Approach to Denial Management and A/R

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Missing or incorrect information collected at any point in the healthcare revenue cycle can ultimately result in a claim being denied. The use of bots and AI by insurers is also making it easier for them to deny payment. According to a recent survey published by the American Medical Association (AMA), three in five physicians (61%) are concerned that health plans’ use of AI is increasing their prior authorization denials1. Because of this, improving data quality and account follow up is necessary now more than ever. One of the ways to combat this issue is to take a more aggressive, comprehensive approach to both reducing denials and working them with more efficiently.

ReSolve® automates critical business processes, work queues and reports, allowing staff to identify and address denial issues much faster. For even greater efficiency, ReSolve® also provides for the capture and indexing of correspondence documents. Links to the correspondence are then added to our worklists for one-click access and review.  

Implementing Workflow Automation and Tracking Performance

When you’ve done everything possible in your bill editing to prevent unnecessary errors, account follow-up can be limited to only those issues that truly need a collector’s attention. ReSolve® Denial Management is a comprehensive workflow solution designed to improve cash by enabling follow-up staff to work and resolve more accounts, reduce cost to collect by automating follow-up activity, reduce A/R days by enabling you to predict and prevent denials, and to track performance with dynamic, drill-down reporting and charting tools. The results are reduced costs, lower A/R days and improved collections.

ReSolve® Solution Benefits include:

  • Automated payment posting: Streamlining and automating the capture and posting of payment information
  • Payment variance resolution: Identifying and resolving payment variance issues
  • Credit balance account follow-up: Identifying and resolving credit balance accounts
  • Aged account follow-up: Identifying and managing accounts that have been billed, but no payment or denial has been received
  • Claim status follow-up: Begin early follow-up on denials using claim status
  • Uncoded/unbilled charges follow-up: Identifying and resolving uncoded/unbilled charges
  • Automated denial reconciliation: Automatically closes denials when manual payments or adjustments are made in your billing system
  • Detailed drill-down reporting and scorecards by division, payor, location and more
  • Customized denial worklist parameters by account balance, aging from billing, discharge, or last follow-up date

About RCMS and ReSolve®

Utilizing AI and workflow technology, each ReSolve® module substantially increases data capture and business process automation in key areas of need for hospitals, physician groups or health systems. These inter-related, layered modules are designed to attack specific deficiencies in common revenue stream processes that typically need improvement and waste valuable staff resources.

ReSolve® is complimentary to existing billings systems, also known as ‘host systems’, and other disparate software technology. As systems integrators, RCMS can connect these various Healthcare Information Systems (HIS) with RCMS designed interfaces, in addition to those of our business partners.

Contact RCMS today to learn more about all of our Revenue Cycle Management solutions and services. Contact us online — or call 440–671–7750.

Citations

1American Medical Association (AMA): February 25, 2025 – Physicians Concerned AI Increases Prior Authorization Denials.

Lockbox Correspondence Management software technology

Technology Solutions for Managing Lockbox Correspondence Documents

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RCMS brings decades of business office and software technology experience that helps to improve and/or eliminate inefficient, manual processes within the revenue cycle. One of our strategies to increase productivity and to minimize delays in reimbursement is with the implementation of automated workflows, facilitated by solutions that provide quick access to indexed, searchable correspondence documents. This allows staff to better manage patient accounts, decrease the number of days to receive payments and to improve their customer service capabilities.

Using advanced programming and several forms of Artificial Intelligence (AI), such as Robotics Process Automation (RPA), Intelligent Data Capture (IDC), OCR/ICR, auto-indexing and auto-classification, RCMS is able to efficiently capture 100% of all paper and electronic lockbox documentation, including scanned mail; PDFs; faxes; email; and other data. Our ReSolve® A/R Management Platform then automates the routing of all correspondence, directing documents to designated worklists, departmental work queues and patient account records.

We can also use technology to link documents within various worklists to be viewed on a separate monitor or window with one click. This can be significantly beneficial toward making improvements with reducing and preventing denials, re-submitting claims and with collection activities in Accounts Receivables (A/R).

Correspondence Management Benefits

The key to effective correspondence management is having the right software technology in place. Our solutions can provide significant time-saving benefits in many areas, including:

  • Reduced inefficient time spent with paper handling and scanning of documents
  • Faster routing of correspondence to appropriate personnel and work queues
  • Improved data quality and accessibility to patient care and insurance coverage information
  • Automated workflow processes that increase speed and drive revenue cycle improvements
  • Facilitates EOB to 835 conversion and check matching for treasury reconciliation
  • Systems Management support for OnBase® Enterprise Content Management (ECM)
  • Can be integrated with all major EHR/EMR and PM Systems (see our Systems Integration capabilities)
  • Improved patient satisfaction with better, timely service
  • Scalable, multichannel infrastructure that can grow with mergers and acquisitions
  • Enforcement of records management policies for legal and regulatory requirements
  • Improved employee satisfaction with less time spent retrieving and requesting documents

Contact RCMS

Our Correspondence Management solutions drive operational efficiencies, minimize delays in receiving payments and help to improve customer service. Contact RCMS today about improving your business office efficiency and all of your revenue cycle processes.

ReSolve® is a registered trademark with the United States Patent and Trademark Office (USPTO). OnBase® is a registered trademark of Hyland Software, Inc.