RCMS to Exhibit at the 2024 HFMA Conference in Las Vegas

RCMS, LLC is proud to announce that we will be exhibiting at the upcoming HFMA Annual Conference, this June 24-27 at the Manadalay Bay Resort & Casino in Las Vegas, NV. The theme of this year’s conference is “A New Frontier in Health”.

Stop by and visit us in booth #642 where we will be featuring the ReSolve® A/R Management Platform, along with our trade show favorite treasure chest filled with $100 dollar bills! Exhibit hours will be held on Monday, June 24th, Tuesday, June 25th, and Wednesday, June 26th.

For more information on the conference and how to register, visit HFMA 2024 Annual Conference.

About the Healthcare Financial Management Association (HFMA)

HFMA empowers healthcare financial professionals with the tools and resources they need to overcome today’s toughest challenges. From online education and certifications to critical regulatory analysis, the benefits of membership are designed to help you create a sustainable future for your organization. Find out more about membership options and the benefits of joining the HFMA at https://www.hfma.org/.


Contact RCMS

RCMS and ReSolve® can substantially improve key areas of need in your business office. With our ‘bolt-on’ technology enhancing and integrating to your existing host billing system(s), key A/R management objectives and workflow automation can be systematically targeted and achieved.

 Contact RCMS about improving revenue cycle management processes for your organization.


Fundamental Design Principles for Effective Cash Management

What are your revenue cycle improvement goals for 2024 and beyond? By integrating with your EHR host billing system (or multiple systems), Clearinghouses and other Line of Business (LOB) applications, the RCMS ReSolve® A/R Management Platform can automate workflows that significantly improve a wide array of 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.

Steps Toward Improving Cash Management:

  • Integrate with host billing systems
  • Synchronize data for adjustments and transfers
  • Same day processing of today’s receipts
  • Use best available capture solutions
  • Capture all adjudication data
  • Automate the separation of remittance with parsing/splitting technology
  • Use data validation rules to cleanse, scrub and normalize payment data
  • Provide reconciliation from bank deposit through billing system to corporate general ledger (GL)
  • Monitor key revenue cycle performance metrics by payor, provider, or division
  • Identify the source of denied claims to resolve the root cause
  • Ensure that claim processes are audited to stop recurring denials

By integrating multiple healthcare information systems and revenue cycle applications with a common A/R Management Platform, RCMS can increase productivity, automate workflows and identify defects for timely adjudication. These steps will improve your cash management processes and reduce your cost to collect.

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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 revenue cycle processes for your entire business office.


ECM and RCM steps to automation

Linking Enterprise Content Management with Revenue Cycle Automation

Six Steps Toward Taking Control of Your Business Office

Unstructured content plagues practically every healthcare organization. It’s the data that resides outside your organization’s core systems and processes. For patient care, it’s the patient information that exists outside your EMR. In patient finance, it’s the data outside your billing and financial systems. And in accounting, it lives beyond the reach of your ERP system. In this article, we look at six steps to manage content contained within these systems – in all file formats. Each step makes life easier for the people who rely on efficient access to current information.

Before thinking of new ways to better manage your unstructured content, you first need to understand what it is. For each organization, this content can exist across an assortment of documents and information spanning all departments. For example, in patient access, unstructured content can be everything from patient ID’s and insurance cards, to consent forms and waiver documents. In accounting departments, invoices and the information surrounding specific financial transactions often exist as unstructured content. Paper encounters, patient correspondence, EOBs and EDI transactions similarly hamper processes in patient financial services. The list goes on, but the key here is to understand the nature of the business content each work area processes. Talk to the people who deal with these issues every day. Then you can take steps to determine the best practice approaches to get it under control.

Odds are, paper and other physical content like forms, letters, photocopies and paper remittances are in someone’s way. Sifting through a stack of EOB’s for that one piece of paper that a patient account representative needs leads to frustration and reduces time spent collecting on outstanding accounts. It also increases the likelihood that another piece of information may be lost or misfiled. Even if your organization’s paper content is safely stored in a central filing location or document imaging system, those storage or indexing costs would likely be better allocated to collecting outstanding funds. Here’s where Enterprise Content Management (ECM) linked with Revenue Cycle Management (RCM) automation can help.

A unified ECM and RCM solution allows you to capture the diverse range of information and content within your organization – paper EOB’s and correspondence, faxed orders or requests for information, denied claims, insurance cards, patient IDs and more. By automating the capture of this documentation and combining the process of data collection with document indexing, the results can be astonishing.

First, that business content required for your HIS application is often the same data required for keyword index values to store and retrieve that same document. Additionally, ECM eliminates the need for physical storage and management, thereby reducing staff’s frustrations about navigating through a mountain of paper to find what they need. Saving on storage, indexing and filing costs also demonstrates a true return on investment that is sure to please everyone in your organization.

Capturing unstructured content is only the beginning. While many solutions stop at this point, if the data is not accurate, it has little to no real value. Today’s best practice solutions include client definable data validation routines that scrub extracted data and help determine the validity of converted data values. Why is Data Validation important? Well, with reimbursement rates shrinking and the cost to collect increasing, every denied claim represents an additional twenty-five to thirty dollars of cost for an organization.

To tackle these challenges, data validation routines help scrub the data to ensure its accuracy before generating the desired output. If errors are found, users have the ability to correct them during an “edit phase,” replacing the original converted data by simply keying the correct information, selecting data from a drop down list, or auto-populating the data from a database lookup. This work process ensures that correct information is available for resolving future issues such as patient billing, denied claims, disputed amounts or other patient inquiries.

Now that you’ve captured and cleansed that unstructured content, you need somewhere to store it. An ideal RCM solution provides you with a single, secure ECM repository for electronic storage of this business content. This helps reduce complexity in your IT environment by eliminating disparate, disconnected content silos.

Unstructured information also poses a security risk. An ECM solution (such as Hyland’s OnBase Platform) securely stores this content, reducing the risk of a HIPAA violation. Additionally, RCM/ECM systems that provide audit trails make compliance with 3rd party audits, Joint Commissions, Sarbanes Oxley and other initiatives much simpler – making life easier for both users and constituents.

For your content to be useful, the people who need to access it should be able to find it easily and quickly. By integrating with your organization’s core applications, an ECM solution provides instant access to content within those systems with a simple click of the mouse. For those in patient financial services, it means finding transactional billing data within the billing system instead of on an EOB or isolated EDI transaction. For those in finance and accounting, it means locating an invoice directly within the ERP system.

Ideally, users of a well-integrated RCM solution might not even be aware of its existence. They simply find what they need within the systems they know and use every day. Not only does this make them more productive, it also enhances the value of your existing applications because users have everything they need within your registration system, EMR, billing system, ERP and other applications.

You’ve identified your business content, captured and validated it, safely stored it and integrated it with your core systems. With an integrated RCM/ECM solution, you can use that content to help your staff work more efficiently.

For example, data warehouses can be automatically created or populated to provide drill-down business analytics. This provides benefits such as identifying collections trends with outcomes, integrating daily cash receipts to the bank deposits for bank reconciliation, or forecasting future cash flows from unbilled charges. Users, managers, directors and executives can work more efficiently within predictable parameters. As a result, your operations run more smoothly and efficiently, with staff more productive and content.


By capturing and routing correspondence through rules-based workflows, solutions such as our ReSolve® Correspondence Management facilitates items being entered and worked faster. Linked to ECM, we leverage Artificial Intelligence (AI) and Robotics Process Automation (RPA) to eliminate manual errors and to automate many of today’s revenue cycle processes. Contact Us today to schedule a discovery call or a presentation of our capabilities.

Editor’s Note:
A version of this article was originally published by ReMedics, LLC. ReMedics is a sister company of RCMS providing Business Process Outsourcing services to Physician Practice Groups, MSOs, Hospitals and Health Systems.

RCMS at HFMA 2023 Annual Conference in Nashville

RCMS to Exhibit at the HFMA Annual Conference in Nashville, TN

RCMS, LLC is proud to announce that we will be exhibiting in Music City at the upcoming HFMA Annual Conference, this June 25-28 at the Gaylord Opryland in Nashville. The conference promises to “take the Cost Effectiveness of Health to the next level”.

Stop by and visit us in booth #545 where we will be featuring the ReSolve® A/R Management Platform, along with our trade show favorite treasure chest filled with $100 dollar bills! Exhibit hours will be held on Monday, June 26th and Tuesday, June 27th.

For more information on the conference and how to register, visit HFMA 2023 Annual Conference.

About the Healthcare Financial Management Association (HFMA)

HFMA empowers healthcare financial professionals with the tools and resources they need to overcome today’s toughest challenges. From online education and certifications to critical regulatory analysis, the benefits of membership are designed to help you create a sustainable future for your organization. Find out more about membership options and the benefits of joining the HFMA at https://www.hfma.org/.


Contact RCMS

RCMS and ReSolve® can substantially improve key areas of need in your business office. With our ‘bolt-on’ technology enhancing and integrating to your existing host billing system(s), key A/R management objectives and workflow automation can be systematically targeted and achieved.

 Contact RCMS about improving revenue cycle management processes for your organization.


Correspondence & Third Party Follow Up for Revenue Cycle Management

PART 1 of a SERIES

RCMS Revenue Cycle Management Solutions cover 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 this article, we concentrate on three Post-Encounter areas that take place before payment processing, validation and bank reconciliation. These areas include: Correspondence Management; Third Party Follow Up; and Self-Pay/Customer Service.

Correspondence Management

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 the Artificial Intelligence (AI) and other technology, tasks such as auto-indexing, auto-classification and correspondence are routing automatically, directing documents to the appropriate personnel.

Third Party Follow Up

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.

Self-Pay / Customer Service

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.


Payment Processing and Validation Strategies for RCM Improvements

PART 2 of a SERIES

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.


RCMS A/R Collections and Denial Management Workflow

PART 3 of a SERIES

RCMS Revenue Cycle Management Solutions improves 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 your 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 focused on Post-Encounter areas that included Payment Processing Payment Validation and Treasury Reconciliation.

In Part 3, the last of this series, we concentrate on A/R Collections Management, Denial & Appeals Management, Contracts & Payor Rate Verification and Reporting & Data Analytics.

A/R Collections Management

RCMS helps to maximize collections by capturing information from disparate systems and identifying bottlenecks at the various stages of reimbursement. Automation is achieved through seamless integration of account comments and other financial transactions within host billing system, further promoting information sharing throughout your organization. Definable qualification criteria and customizable sorting and filtering make it easy for users to timely 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 organizations cost to collect can be significantly improved.

Denial & Appeals Management

To reduce denial rates, RCMS quickly isolates medical claim denials/defects and prevents future re-occurrences. This increases cash flow and decreases process delays. Denied claims are automatically captured and routed to the appropriate individuals, facilitating timely and effective follow-up with 3rd party payers. Denial trends can be analyzed and traced to specific areas — from patient access and eligibility to individual physicians, departments and type of service. 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 and providing a true process improvement solution.

Contracts & Payor Rate Verification

Having accurate historical data is critical to optimizing payor contract negotiations. RCMS ensures that your organization is receiving the best rate for services by automatically comparing reimbursements against payor contracts. With the payor rate matrix, you can systemically review all remittance data comparing against configured fee schedules. Exceptions are easily identified and routed to worklists for additional research and follow up.

Reporting & Data Analytics

Our ‘connected systems’ approach unlocks the potential of extensive data generated as a result of revenue cycle processes and workflows. RCMS clients can visualize and analyze real-time data with reporting tools that minimize the need for IT support. By providing reporting, drill-down data analytics, pivot charts and scorecards, 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.


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.