Category Archives: Revenue Cycle Management

RCMS Healthcare Consulting Services

Business Process Consulting for Permanent Revenue Cycle Improvements

Posted on

Whether you’re trying to improve specific remittance processing and reconciliation tasks or all of your revenue cycle procedures, RCMS Business Process Consulting (BPC) can help to determine the best approach for your organization. From redesigning workflows to implementing innovative technology, we’ll analyze current barriers and make recommendations for improvement.

Long Term Strategies that Support Permanent Change

  • Identification of opportunities for automation and gains in efficiency
  • Overall improvement of revenue cycle KPIs
  • Implementation of proficiency plans with detailed reporting & analytics
  • Management of billing processes through a merger and/or acquisition
  • Analysis of existing HIT systems, clearinghouses and banking partnerships
  • Development of single tax ID reporting with division autonomy
  • Integration options with EMR billing applications and General Ledger (GL) software
  • Analysis of planned or existing outsourced services
  • Incorporating efficient work queues for denial management & follow up

Scalable Solutions for the Healthcare Business Office

Depending on the engagement, our improvement strategies can include all areas of the revenue cycle, delivering scalable solutions that increase staff efficiency and add flexibility to your Business Office. Once we have a defined scope of work, the consulting team will provide our recommended actions and a realistic timeline for implementation.

Working with RCMS Consultants

Our consulting services can recommend process improvements in all areas of the revenue cycle, from Patient Access and Registration to A/R Management and Collections. Contact RCMS about making your organization more efficient and profitable.

RCMS Business Intelligence for RCM

Improving Your Revenue Cycle with Enterprise Business Intelligence (BI)

Posted on

Uncovering hidden trends within your billing and payment data can play a critical role in developing a strategic, successful revenue cycle plan — and in monitoring the progress of incremental modifications. This is especially true when implementing changes across a network of disparate financial applications and processes. RCMS’ systems integration experience and capabilities facilitate seamless data exchange between multiple HIT Systems, Banks and Clearinghouses, streamlining workflows and improving accuracy.

RCMS solutions include customized Power BI Scorecards that can help to drive accelerated, intelligent decision making in your revenue cycle. To start, we provide the means to capture and process all payments, denials, exceptions, adjustments and follow up activity from multiple business systems into our ReSolve® A/R & Workflow Automation platform. This allows for a variety of scorecards to be created by payers, business units, specialty groups and facility locations. With drill-down reporting and visualization features provided by Microsoft’s Power BI, our scorecards help to quickly identify and correct problematic areas that lead to sustained, measurable improvements.

RCMS and Power BI Reporting Benefits

  • Systems integration experience with healthcare delivery networks
  • Ability to connect with disparate data sources
  • Customized scorecards for each revenue cycle area
  • Accelerated decision making with real-time data visualization
  • Denials scorecard by payers, physicians, business units and locations
  • Analytic data available from desktop, tablet or smartphone
  • Ability to share scorecards with all department managers
  • Options for self-serve reporting & dashboard manipulation

Contact RCMS to Discover the Full Potential of your Revenue Cycle

RCMS can help Regional Hospitals, Health System IDNs and Practice Groups to leverage and enhance their current EHR/EMR/PM business applications. By identifying negative trends and inconsistencies across multiple sources of claim and payment information, we can help to develop changes and/or make corrections to current technology and processes. Contact RCMS today to discover the full potential of your revenue cycle.

HFMA Western Symposium RCMS ReSolve A/R® Management

RCMS to Exhibit at the HFMA Western Region Symposium

Posted on

RCMS, LLC is proud to announce that we will be exhibiting at the upcoming HFMA Western Region Symposium, this January 19-22 at the Paris Las Vegas Hotel & Casino — bringing together HFMA members from Regions 10 & 11. This special event is all about connecting individuals who work in hospitals, health plans, physician practices and others in healthcare settings by creating an environment to educate, connect and motivate!

Visit RCMS in Booth #140 for a Chance to Win $100!

Stop by and visit us in Booth #140 where we will be featuring the ReSolve® AI & Workflow Automation Technology, along with our trade show favorite treasure chest filled with $100 dollar bills! Exhibit hours will be held on Sunday, Monday & Tuesday, January 19-21, 2025.

Continuing Professional Education (CPE) Credits

Upon verification of participant attendance, Western Symposium programs will be eligible for CPE credits in various fields of study. Credits may vary depending on individual state guidelines. For more information on the symposium and how to register, visit HFMA Western Symposium.

About Healthcare Financial Management Association (HFMA)

HFMA empowers healthcare financial professionals with the tools and resources they need to overcome today’s toughest challenges. From online education and certifications to critical regulatory analysis, the benefits of membership are designed to help you create a sustainable future for your organization. Find out more about membership options and the benefits of joining the HFMA at https://www.hfma.org/.

Contact RCMS

RCMS and ReSolve® can substantially improve key areas of need in your business office. With our on-premise bolt-on technology enhancing and integrated with your existing EMR/PM host billing systems, key revenue cycle and A/R management objectives can be systematically achieved.

 Contact RCMS about improving revenue cycle management processes for your organization.

ECM Platforms and Revenue Cycle

Leveraging ECM with Your Revenue Cycle Management Objectives

Posted on

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.

Lockbox Correspondence Management software technology

Technology Solutions for Managing Lockbox Correspondence Documents

Posted on

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.

Automating RCM Workflow for Multiple EHR/EMR Systems

Posted on

For larger hospital systems and IDNs with multiple facilities, they can often include hospitals, clinics and physician practice groups with disparate EHR/EMR and Practice Management (PM) systems. Processing claims and payment information from multiple systems and clearinghouses can create certain challenges that result in business office inefficiencies and lost revenue.

The goal of RCMS is to collect all of the claim, payment and deposit information needed to post and reconcile on one platform, so that automating revenue cycle processes can be optimized for the highest level of data accuracy and workforce efficiency. Customized rules can also be applied in the workflow for specific client requirements, such as allocating funds to divisions or for routing defects and exceptions to specific groups or work queues. We also use this ‘aggregated data’ to create a more complete analysis of the revenue cycle throughout the entire organization, eliminating the need to manually duplicate information to spreadsheets for management and reporting purposes.

Implementing Solutions Across People, Processes and Technology

For Health Systems and IDNs with multiple EHR/EMRs and PM systems, our ReSolve® A/R Management Platform provides the means to consolidate resources and improve business office processes – providing additional time for more productive tasks such as A/R collections and customer service. By using Intelligent Automation (IA) for improving workflow processes across multiple systems, we can significantly reduce and/or eliminate repetitive data entry that is prone to human error and a waste of valuable resources. Our integration with OnBase ECM, also provides significant staff efficiency with being able to retrieve and view correspondence documentation, indexed to the patient account.

In supporting a multi-system, complex business environment, some of the many benefits of ReSolve® include:

  • Automated repetitive tasks in conjunction with machine learning
  • Automated splitting/parsing of EDI transactions for more efficient processing
  • Connects multiple billing systems where APIs don’t exist
  • Hospitals and Practice Groups can maintain existing EHR/EMR and PM Systems
  • All ERA correspondence can be captured and indexed to the patient account for data validation, evidence of pre-authorizations and efficient follow up
  • BAI integration for full bank reconciliation from deposits to the individual billing systems
  • Robust reporting tools with integration to Microsoft Power BI and SSRS data visualization
  • Data analytics with drill-down capabilities for decreasing and preventing denials – and for creating permanent revenue cycle improvements
  • All revenue data is stored for auditing compliance with regulatory requirements
  • Workflow solutions for Eligibility (270 / 271) and Claims Status (276 / 277) inquiries
  • Allows staff to be more productive and focus on higher-value work

Working with RCMS

In partnership with your Accounting and IT teams, RCMS can work with your organization to develop a strategic plan that explores all areas of the revenue cycle. We bring decades of healthcare business office and software design experience that will help to improve your operations. Contact RCMS to schedule a discovery call or presentation of our company and its technology.

Healthcare Bank Treasury Reconciliation

Enterprise-Level Reconciliation from Posting to Deposits

Posted on

Providing end-to-end reconciliation, from payment posting to bank deposits, ReSolve® Treasury Workstation 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, without the need of third-party spreadsheets or manual re-entry of data.

ReSolve® Treasury Workstation automates the capture of electronic deposits received from your bank’s Banking Association Institute (BAI) data to create the source record for enterprise-level reconciliation. This includes multi-system environments in a centralized business office with two or more EHR/EMR billing systems.

With batch tracking and artificial intelligence (AI), all data is divided into four (4) areas: Bank Deposits; Treasury or Cash Journal; RCMS’ ReSolve® Payment Distribution; and the Host Billing System(s) for payment disbursements. The Cash Journal displays the Finance Department’s batching process for all deposits. The RCMS user interface displays the batches as posted in its Payment Processing system, and the Host Billing System displays batches as distributed to each unique billing system.

Contact RCMS

Are you ready to automate and improve your business office? ReSolve® provides workflow automation and data quality benefits that significantly improve revenue cycle processes and KPIs — with synchronize data for adjustments and transfers.

Contact RCMS today to schedule a discovery call and demonstration.

Related Articles

Fundamental Design Principles for Effective Cash Management

Posted on

What are your revenue cycle improvement goals for 2024 and beyond? By integrating with your EHR host billing system (or multiple systems), Clearinghouses and other Line of Business (LOB) applications, the RCMS ReSolve® A/R Management Platform can automate workflows that significantly improve a wide array of cash management and revenue cycle processes.

Below are some of the key areas we address when working with our Integrated Delivery Network & Health System clients.

Steps Toward Improving Cash Management:

  • Integrate with host billing systems
  • Synchronize data for adjustments and transfers
  • Same day processing of today’s receipts
  • Use best available capture solutions
  • Capture all adjudication data
  • Automate the separation of remittance with parsing/splitting technology
  • Use data validation rules to cleanse, scrub and normalize payment data
  • Provide reconciliation from bank deposit through billing system to corporate general ledger (GL)
  • Monitor key revenue cycle performance metrics by payor, provider, or division
  • Identify the source of denied claims to resolve the root cause
  • Ensure that claim processes are audited to stop recurring denials

By integrating multiple healthcare information systems and revenue cycle applications with a common A/R Management Platform, RCMS can increase productivity, automate workflows and identify defects for timely adjudication. These steps will improve your cash management processes and reduce your cost to collect.

Related Articles

Contact RCMS

Contact RCMS today to improve your cash management with the right design principals, systems integration experience, and software technology. We’ll help to improve revenue cycle processes for your entire business office.