Connecting HIT with Systems Integration

Connecting Disparate Systems to a Single A/R Management Platform

Systems Integration for Aggregated Environments

Ensuring the smooth flow of claims from the Provider to the Payor, as well as funds from the Payor back to each Hospital or Practice Group, requires several different supporting organizations to receive and share information.

RCMS specializes in the capture and conversion of all data types from disconnected information silos, including HIT, Clearinghouses and Banking systems. This allows us to leverage the most current Robotics Process Automation (RPA) and AI Machine Learning technologies to efficiently verify and/or correct defects that can delay or reduce revenue from being collected. As a result, our ‘connected systems’ approach unlocks the potential of extensive data being generated from all your claims and remittance processes.

By capturing information from disparate systems and identifying bottlenecks at the various stages of reimbursement, our ReSolve® A/R Management Platform helps to maximize collections. Automation is achieved through seamless integration of account comments and other financial transactions within the host billing system(s), further promoting information sharing throughout the organization.

ReSolve® worklisting tools provide for definable qualification criteria, customizable sorting and filtering that makes it easier for users to resolve account deficiencies. By being proactive in account follow-up and having tools which present financial and clinical data in a user-friendly solution, your organization’s cost to collect can be significantly improved.

A significant amount of time and attention in revenue cycle management is reactive. Fixing claim errors, looking for missing information and reworking denials that ultimitely lead to delays and lost revenue. With the ReSolve® platform, bottlenecks and errors in processing claims, reconciling payments, and with managing denials can be analyzed and traced to a specific location, department or type of service. By connecting systems and data in an aggregated business environment, we can provide pre-scheduled reports, scorecards and analytical data that helps to identify hidden trends, isolate problem areas and implement changes that lead to permanent revenue cycle improvements.

Our Revenue Cycle Management (RCM) Strategies are a blend of Data Capture, Workflow Design, RPA, AI, Enterprise Content Management (ECM) and Systems Integration — connecting HIT systems, Clearinghouses, Banking partners and other Line of Business (LOB) applications to maximize efficiency. Contact RCMS today to schedule a call.

Key Solution Drivers for Creating Permanent Revenue Cycle Improvements

Implementing Efficient Data Capture and Workflow Automation

Whether you’re looking to implement a departmental solution or to install enterprise content management throughout the entire organization, RCMS has the ability and expertise to help you with gaining operational efficiencies and to increase revenue.

With the use of advanced data capture technology and robotics process automation, we eliminate wasteful, manual tasks that maximize the efforts of your workforce – while integrating with core business systems and any relevant patient or payor information. This includes the capture and indexing of all claims, remittances and correspondence, no matter how many different EMRs, billing systems, practice management systems and lockboxes are currently being used.

To accomplish your operational and revenue cycle objectives, we focus on creating permanent improvements (with key solution drivers) that can deliver the greatest impact on your bottom line.

Key Solution Drivers

RCMS utilizes the following key solution drivers in designing specific revenue cycle management (RCM) applications and with implementing changes to how information is captured, verified and processed for reconciling and posting payments to multiple systems.

  • Acquire diverse information to provide organized access to critical business records, regardless of format.
  • Unify disparate systems and software applications to improve information flow and automate redundant processes.
  • Streamline operational efficiencies with technology and best practices to deliver sustainable financial results.

About RCMS

With expertise in business office operations, revenue cycle management, and HIS integration, RCMS can improve your business office operations and the financial performance of your entire organization. Our solutions include the ReSolve­® A/R Management Platform, designed for the efficient capture, management and use of patient and payment information to dramatically improve posting accuracy and to exceed RCM benchmarks.

Contact RCMS today to schedule a call or presentation with your revenue cycle teams.

RPA - Robotics Process Automation from RCMS

Using RPA and Workflow Across Multiple EMR & Billing Systems

For RCMS clients with multiple EMR and billing systems, the RCMS ReSolve® A/R Management Platform provides the means to consolidate resources and improve business office processes – without having to eliminate hard to displace, vested applications. One of the many technologies we utilize to do this is robotics process automation (RPA).

Using RPA in healthcare business applications can significantly reduce manual, repetitive processes that are prone to human error and waste valuable time. In partnership with your Accounting and IT teams, RCMS can help your organization to develop an RPA plan that explores all areas of the revenue cycle — where repeated processes can be substantially improved.

Below are just a few examples of how RPA can benefit your organization:

  • Improved accuracy over redundant manual data entry
  • Unattended and attended RPA applications
  • Automates repetitive tasks in conjunction with AI and machine learning
  • Allows staff to be more productive and focus on higher-value work
  • Can move data across HIS applications
  • Connects multiple billing systems where APIs don’t exist
  • Data is stored for auditing compliance with regulatory requirements
  • Adjusts and scales to changes in underlying systems

About RCMS

RCMS brings decades of healthcare business office and software development experience to improve your revenue cycle. We specialize in working with IDNs having multiple EHR/EMRs and billing systems. Contact RCMS for an assessment of your business applications and how you can benefit from RPA to improve your operations.

RCMS Follow Up & Collections

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

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 effect 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.

CBO Multiple Billing System Environments

Reducing Manual Work in CBO Multiple Billing System Environments

As systems integrators, RCMS can connect to multiple Healthcare Information Systems (HIS), in addition to those of our business partners. This includes multiple billing systems for the processing and posting of payments in a Central Business Office (CBO). With this connectivity in place, data-driven decision making can be automated, increasing the accuracy of information being processed – while reducing manual efforts for information capture, image capture, data entry, routing, and verification.

For RCMS clients with multiple EMRs and billing applications, the RCMS ReSolve® A/R Management Platform provides the means to consolidate resources and improve business office processes – without having to eliminate hard to displace, vested systems. ReSolve® is complimentary to existing billings systems, also known as ‘host systems’, and other disparate software technology.

In many cases, ReSolve™ is utilized in complex, multiple billing system environments specifically because of its ability to act as a common front-end interface for the posting of payments.

Central Business Office Keys to Success

  • Streamlined data capture from all systems, banks and clearinghouses
  • Improved processes with data-driven decision making technology
  • Reduced manual efforts with data validation, reconciliation and payment posting
  • Enhanced billing system functionality – at less cost than to upgrade or replace
  • Connected inter-related systems with proprietary custom interfaces
  • Allow for the sharing of information across multiple departments
  • Avoid missing data & incomplete claims, preventing denials
  • Automated payment posting and follow-up worklists
  • Integration & support for OnBase ECM document imaging
  • Detailed management reporting & real-time analysis
  • General ledger (GL) integration capabilities
  • Increased net collections & reduced risk of non-payment
  • Reduced or eliminated click-fee based expenses
  • Long term strategies for the consolidation of resources

Contact RCMS

RCMS and ReSolve® will substantially improve key areas of need in your business office. With our ‘bolt-on’ technology enhancing and integrating your systems, key revenue cycle management objectives, from beginning to end, can be systematically targeted and achieved. Revenue Cycle BPO Services by our sister-company, ReMedics LLC, can also augment our software solutions and provide a long-term continuation of our business partnership.

 Contact RCMS about improving revenue cycle processes for your business office.