Automating RCM Workflow

Automating RCM Workflow for Multiple EHR/EMR Systems

For larger hospital systems and IDNs with multiple facilities, they can often include hospitals, clinics and physician practice groups with disparate EHR/EMR and Practice Management (PM) systems. Processing claims and payment information from multiple systems and clearinghouses can create certain challenges that result in business office inefficiencies and lost revenue.

The goal of RCMS is to collect all of the claim, payment and deposit information needed to post and reconcile on one platform, so that automating revenue cycle processes can be optimized for the highest level of data accuracy and workforce efficiency. Customized rules can also be applied in the workflow for specific client requirements, such as allocating funds to divisions or for routing defects and exceptions to specific groups or work queues. We also use this ‘aggregated data’ to create a more complete analysis of the revenue cycle throughout the entire organization, eliminating the need to manually duplicate information to spreadsheets for management and reporting purposes.

For Health Systems and IDNs with multiple EHR/EMRs and PM systems, our ReSolve® A/R Management Platform provides the means to consolidate resources and improve business office processes – providing additional time for more productive tasks such as A/R collections and customer service. By using Intelligent Automation (IA) for improving workflow processes across multiple systems, we can significantly reduce and/or eliminate repetitive data entry that is prone to human error and a waste of valuable resources. Our integration with OnBase ECM, also provides significant staff efficiency with being able to retrieve and view correspondence documentation, indexed to the patient account.

In supporting a multi-system, complex business environment, some of the many benefits of ReSolve® include:

  • Automated repetitive tasks in conjunction with machine learning
  • Automated splitting/parsing of EDI transactions for more efficient processing
  • Connects multiple billing systems where APIs don’t exist
  • Hospitals and Practice Groups can maintain existing EHR/EMR and PM Systems
  • All ERA correspondence can be captured and indexed to the patient account for data validation, evidence of pre-authorizations and efficient follow up
  • BAI integration for full bank reconciliation from deposits to the individual billing systems
  • Robust reporting tools with integration to Microsoft Power BI and SSRS data visualization
  • Data analytics with drill-down capabilities for decreasing and preventing denials – and for creating permanent revenue cycle improvements
  • All revenue data is stored for auditing compliance with regulatory requirements
  • Workflow solutions for Eligibility (270 / 271) and Claims Status (276 / 277) inquiries
  • Allows staff to be more productive and focus on higher-value work

Working with RCMS

In partnership with your Accounting and IT teams, RCMS can work with your organization to develop a strategic plan that explores all areas of the revenue cycle. We bring decades of healthcare business office and software design experience that will help to improve your operations. Contact RCMS to schedule a discovery call or presentation of our company and its technology.