Payment Processing and Validation Strategies for RCM Improvements


RCMS Revenue Cycle Management Solutions improve a wide range of different patient billing areas where changes to manual work processes and the use of technology can have a significant impact on financial performance. In Part 1 of this Series, we discussed Correspondence Management, Third Party Follow Up, and Self-Pay/Customer Service.

In Part 2, we concentrate on three more Post-Encounter areas, including: Payment Processing; Payment Validation; and Treasury Reconciliation.

Payment Processing

By capturing and routing correspondence through rules based workflows, RCMS provides for items to be entered and worked faster, reducing turn-times and increasing productivity. The result is improved patient satisfaction and reduced callbacks. The key is having a solution capable of capturing correspondence in all forms, including: scanned mail, faxes, emails, or other business systems. Using Artificial Intelligence (AI) and other technology, tasks such as auto-indexing, auto-classification and correspondence are routing automatically, directing documents to the appropriate personnel.

Payment Validation

With patient liabilities continuing to rise, it’s important to find ways to collect co-pays/deductibles earlier in the process. RCMS can help to improve first-call resolutions, patient satisfaction and time to collect patient payments by providing immediate access to both clinical and financial data from both hospital and physician systems. Our proprietary, system generated worklists automatically identify accounts needing proactive follow up. For customer service representatives, our Account Inquiry function within AR Management provides a powerful tracking tool for activities and patient communications.

Treasury (Bank) Reconciliation

By taking a proactive approach to AR management, processing delays are decreased, cash flows are increased, and overall cost to collect is reduced. RCMS provides a complete record of all outstanding payments and a history of denials. Accounts are tracked throughout the payment lifecycle, providing insight into where bottlenecks are occurring in claim generation and adjudication. Aged accounts are routed to user work queues for timely follow up.

About RCMS

RCMS Revenue Cycle Management Improvement Strategies are a blend of Business Management Consulting, Technology Solutions and Systems Integration expertise in connecting Health Information Management Systems (HIMS) and Line of Business (LOB) systems. Contact RCMS about improving the Revenue Cycle for your organization.