RCMS’ solutions can improve a wide range of different patient billing areas where changes to manual work activities and the use of technology can have a significant impact on a health system’s financial performance. With the right tools and workflow processes, first-call resolution and time to collect patient payments can be significantly improved.

Using AI-powered solutions, our technology can prioritize accounts to work claim denials more efficiently. System generated worklists can automatically qualify accounts for proactive follow up. For customer service representatives, account inquiries provide a powerful tracking tool for A/R collections and patient communications.

By being proactive in account follow-up and having automated tools to present financial and clinical data in a user-friendly solution, your A/R Management KPIs can be significantly improved.

Denial & Appeals Management

To reduce denial rates, our ReSolve® AI & Workflow Automation technology can isolate medical claim denials/defects and prevents future re-occurrences. This decreases processing delays and helps to maintain cash flow. By identifying the source of each denied claim, Denial Management allows staff to resolve the root cause of denials, thereby reducing the initial denial rate of future claims. ReSolve® can also facilitate decisive activities with predesigned correspondence and tracking capabilities, from generating appeals through rebilling and payment. Department supervisors can also track follow-up pursuits by user and work queue, enhancing departmental oversight and staff performance.

Identifying Hidden Trends and Isolating Problem Areas

With access to claims and revenue cycle data from the Hospital the Physician Practice Group’s HIT Systems, RCMS clients can visualize and analyze real-time data using Microsoft’s Power BI and SSRS reporting tools. By providing drill-down data analytics, pivot charts and scorecards in our reporting options, managers and executives can quickly identify hidden trends, isolate problem areas and ensure that they have an up-to-the-minute view of their revenue cycle operations.

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
• Proactively work denial defects and true denials
• Provide reconciliation from bank deposit through billing system to GL
• Monitor KPIs and performance metrics

Minimizing Disruption to Cash Flow with System Migrations

By integrating with all of your Line of Business (LOB) applications, RCMS can improve data accuracy and automate workflows to significantly enhance revenue cycle and treasury management processes. Our proven ReSolve® technology also provides for a more strategic and successful migration plan to a new EHR/EMR system – with minimal disruption to cash flow. 

Contact RCMS about improving revenue cycle operations for your organization.

---