Bridging the Revenue Cycle Gap in Multi-System Environments

Posted on January 6, 2025February 6, 2025

For many Health Systems and Integrated Delivery Networks (IDN) that have grown through mergers and acquisitions, there is typically going to be a period of time when claims need to be billed through multiple EMR and Practice Management (PM) Systems. In a perfect world, migrating to a single system for professional billing and hospital billing (for all facilities) would be a relatively straightforward process. As most have realized, however, it can take years of coordination and a significant investment in resources to make that happen.

In a recent article published by Becker’s Healthcare, they reported that several large Health Systems had EMR installation costs in excess of $500 million. In other reports, the implementation timeline for some of the systems was typically 2 to 3 years. Once fully migrated to a new EMR, legacy systems may still need to be kept online for an unknown period of time.

Optimizing Business Office Processes Throughout a Provider Network

RCMS’ proprietary technology and systems integration experience allows us to specialize in the capture and management of aggregated data from disparate EMR and PM Systems, Clearinghouses and Banks. We then leverage workflow automation technology to optimize revenue cycle processes throughout a provider network — from remittance processing and treasury reconciliation to appeals and collections. Designed to parse and reconcile payments for any number of facilities or divisions in co-mingled batch files, our ReSolve^® Platform becomes a customized, system agnostic front-end solution that bridges the revenue cycle gap in multi-system environments for as long as needed.

Utilizing AI and Workflow Automation

RCMS utilizes several different forms of Artificial Intelligence (AI), including Robotics Process Automation (RPA) and Machine Learning Technology, in order to enhance and automate workflows for a wide variety of revenue cycle and A/R management processes. With ReSolve^®, customized rules are applied in the workflow for a client’s requirements, such as routing denials and exceptions to specific work queues for more efficient corrections and appeals. By integrating with all host billing systems and other Line of Business (LOB) applications, RCMS can provide for a more strategic and successful migration – with minimal disruption to cash flow.

Working with RCMS

Our services and solutions provide process improvements in all areas of the revenue cycle. Contact RCMS about managing your business office more efficiently – and to help with developing a more successful EMR systems migration strategy.

ReSolve^® is a registered trademark of Revenue Cycle Management Solutions, LLC (dba RCMS, LLC).

Enabling Enterprise-Level Reconciliation and Audit Controls

Posted on October 28, 2024March 6, 2025

In many of today’s Health Systems with multiple Hospitals, Clinics and ASCs, disconnected legacy applications and other sources of data 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.

Automated Matching and Reconciliation of all Posted and Distributed Remittance

Posted on June 3, 2024May 1, 2025

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.

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