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.
Information Sharing and Automation
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.
Implementing Permanent Revenue Cycle Improvements
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.