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.


ECM and workflow solutions for all industries

Cost-Saving ECM & Workflow Solutions For All Industries

Automated Processes — Tailored to Your Business Needs.

While the main focus for RCMS is in providing technology to the healthcare market, our document management and workflow solutions can also be applied to many other business sectors. Just like healthcare, industries such as education, energy, financial services, insurance, and manufacturing continue to rely on a variety of decentralized electronic and paper-based documentation. In most cases, these documents and their corresponding data (such as customer no.) get stored in disparate information silos that lead to a wide variety of process inefficiencies and lost revenue.

RCMS solutions, including Hyland Software’s OnBase Enterprise Content Management (ECM), can be used to capture, index, and route any type of document and electronic file format in a single database. With ECM, disparate documentation can be organized and efficiently provided throughout a department, division, or worldwide network. ECM also provides for significant other benefits, such as audit trails, controlled access (by department or role) and fiduciary reporting.

Artificial Intelligence (AI) and Workflow Automation

Using AI with indexed documentation allows for the use of workflow automation to significantly reduce manual, repetitive processes. Working with your department managers and IT team, RCMS can develop a plan that explores all areas of your organization where repeated processes can be substantially improved. By automating repetitive tasks and worklists in conjunction with AI and machine learning, we can create processes that allow staff to be more productive and focus on higher-value work.


About RCMS

RCMS brings decades of business process experience to your specific departmental needs or for an entire organization. We specialize in connecting ECM to different systems and corporate financial applications, including AR, AP and GL. Contact RCMS for an assessment of your business needs and how we can improve your operations.


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.


ECM and Workflow for healthcare revenue cycle improvements

Improving Operational Efficiencies with ECM & Workflow

Are you ready to transform your business office?

With enterprise content management (ECM) and our custom workflow solutions, RCMS can transform static, unstructured information and documents into a dynamic part of your business office operations. Utilizing Hyland’s OnBase ECM software and the RCMS ReSolve® A/R Management Platform, our automated workflow technologies seamlessly integrate to your billing applications and revenue cycle processes, reducing and/or eliminating many of the inefficient, manual processes that require staff intervention. Using advanced document management programming tools, such as auto-indexing and auto-classification, correspondence routing becomes automated, directing documents to designated worklists and departmental work queues. By integrating multiple healthcare information systems and ECM with a common user interface, RCMS can increase productivity, identify defects for timely adjudication, and reduce your cost to collect.

ECM & Workflow Benefits

RCMS provides significant time-saving benefits in many areas, including:

  • Reduced manual tasks and data entry errors
  • Correspondence document management & indexing for quick retrieval
  • Data extraction & normalization of paper-based documents
  • Improved operational efficiencies and turnaround times
  • Integration with other business applications
  • Real-time analytics, reports and scorecards
  • Hosted or on-premise ECM deployment
  • Accountability and audit trails for all processes
  • Professional services team specializing in healthcare claims & billing
  • Easy-to-use intuitive interfaces and HIPAA compliant, secure access


About RCMS

RCMS brings decades of healthcare business office and software development experience to improve your revenue cycle. We can provide hosted or on-site document management and workflow solutions that provide staff with quick access to indexed, searchable documents in all formats. Contact RCMS about improving your operations.


RCMS Cash Management Prinipals

Cash Management Fundamental Design Principles for 2023

What are your revenue cycle improvement goals for 2023? By integrating with host billing systems, practice management systems, and other line of business (LOB) applications, RCMS can automate workflows that will significantly improve your 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.

Keys to Improving Cash Management:

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

By integrating multiple healthcare information systems (HIS) and Hyland’s OnBase enterprise content management (ECM) system with a common user interface, RCMS can increase productivity, identify defects for timely adjudication, and reduce your cost to collect.


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 processes for your entire business office!


Automated EDI Parsing Splitting Software

Case Study: Automated Parsing of EDI Transactions

Client Background:

The client is a large podiatry practice group that provides a full range of specialty services for the advanced treatment of foot and lower extremity conditions. The group has over 100 board certified podiatrists, providing medical services through a network of approximately 80 office locations. They are backed by a private equity investment firm that specializes in healthcare service investments.

Challenges:

The payment posting team was receiving EDI transaction payments for multiple business units/divisions within a single ERA file from their clearinghouse. Further complicating matters, each practice was being migrated to a new Practice Management platform as part of their onboarding process. In order to process remittances more efficiently and reduce work on the back-end of the revenue cycle, they needed a solution that could split payment data to the appropriate business unit’s practice management (PM) system as it was being received.

They also had a requirement to automate the splitting of payments processed without matching claim data. These payments included claims billed with attachments, as well as secondary billing, worker’s compensation, and other requirements for processing outside of the submitting clearinghouse.

The Solution:

  • ANSI 835 files are received from the client’s clearinghouse on a daily basis, where ERA/EDI files are ingested into a proprietary Single Cash Management System solution for data splitting, validation, and reconciliation.
  • Data is matched against corresponding claim feeds (ANSI 837 files) and reconciled to updated check/batch data contained within the ANSI 835 transactions.
  • Through custom configuration and multi-level splitting logic contained within the processing solution, corresponding payments and denial data are assigned to the appropriate EMR or PM system.
  • An optional RCMS hosted document management system is available to index and retrieve all transactional payment/ERA data for EOB storage and retrieval.

The Results:

Using advanced data capture and Business Process Automation (BPA) technology, RCMS ensures that all updated and re-balanced payment files are distributed to each business unit on a daily basis — and reconciled back to the check and original 835 file received from the Clearinghouse. The client no longer has to split and transfer payments “downstream” for each business unit, resulting in more timely and consistent cash flow.

Daily payment balancing and posting reports are delivered to the client to assist with distribution, reconciliation, and identification of processed work. RCMS also provides a separate electronic 835 ERA file and corresponding reports for any transactions that do not qualify for a pre-defined entity, such as transactions that contain any unidentified payments for external systems that fall outside of the project scope.

Due to the efficiencies created by these services, the client is able to devote more time towards business expansion initiatives. Client personnel can now quickly search and retrieve electronic files by Business Unit, Patient Name, Check Number, Service Date, Paid Amount and many other options to quickly identify information needed for payment posting or follow-up activities.

Positioned for Growth

With the RCMS technology in place, new business units can quickly be added to the Client’s existing EDI splitting and payment processing services — while continuing to use their current practice management system(s). By adopting a multi-submitter, single receiver workflow to capture all their payments, acquired or merged groups maintain their billing autonomy while reporting up to a single corporate Tax ID through their PM system conversion plan. At a future date in time, RCMS can help to develop and implement a systems migration strategy to a common platform.


Editor’s note: this case study was also published by ReMedics LLC, our sister BPO services company that provides outsourced remittance processing, data validation and bank reconciliation support to physician practice groups and management services organizations (MSOs) throughout the United States.


Contact RCMS

RCMS can deliver proven EDI data capture and parsing solutions that provide for significant productivity gains in your business office. Contact RCMS about improving staff efficiency and organizing your business information.