REVENUE CYCLE MANAGEMENT SERVICES

Code medical claims, collect payments, determine eligibility of the patients, and keep a track of the claims with the help of our expert healthcare team

Revenue Cycle Management or RCM is an extremely important procedure in healthcare and is single-handedly responsible for ensuring that healthcare providers payment, claims processing, and revenue generation procedures work effectively. Outsource2india, a leading revenue cycle management service providing company, can manage the entire revenue cycle starting from a patient's admission to the hospital, treatment, and discharge, to post-discharge claims and accounts settling. With our help you can benefit from accelerated cash flow, structured and organized operations, faster revenue realization, and constant monitoring of key revenue cycles.

Our Revenue Cycle Management Services

1.        Accounts Receivable Analysis

Our AR analysis team can provide you with an accurate analysis of your account receivable accounts with ease. Our services will help you revamp your facility's economic structure at an affordable price.

2.        Accounts Receivable Follow-up

We have the required tools and technologies to ensure that we regularly follow-up with your accounts receivable accounts. We provide our clients with accurate healthcare AR follow-up, AR recovery services, online claims follow-up, financial reports creation, etc.

3.        AR Calling Services

We have a dedicated team to handle all your AR calling needs. We ensure that you do not spend on hiring an in-house team and boost your ROI. We can help you track unpaid claims, manage patient's collectible, generate AR reports, and track electronic and paper claims efficiently.

4.        Denial Management Services

Denials occur due to incorrect patient information, improper documentation, invalid medical codes, etc. By outsource denial management service to us, you can rest assured that all your details are correct and all documents are verified in order to reduce the number of denials.

5.        Insurance Eligibility Verification

Our healthcare team at O2I has the required skills and expertise to provide clients with accurate insurance eligibility verification. We can help you with document verification, patient insurance coverage verification, claim submission, etc.

6.        Dental Insurance Verification

We help small and mid-sized dental practitioners and companies with high-quality dental insurance verification services. We provide them with verification of various details such as policy status, payable benefits, co-insurance details, insurance plan exclusions, etc, apart from offering health insurance recovery services.

7.        Medical Insurance Claims Processing

Outsource2india is one of the experts in medical insurance claims processing and have been catering to the needs of clients for over two decades now. We can help you with claim setup, verification, document imaging, claim adjudication, disbursement, account settlement, etc.

8.        Payment Posting

Payment posting marks the end of the billing cycle where the patient records are entered into the billing software. Our team at O2I can help you at each and every stage of the process leveraging the latest and the best medical billing software in the market.

9.        PPO Health Insurance Claims Repricing

Our team of healthcare billing experts can help you with accurate PPO health insurance claims repricing. We have the expertise to provide clients with the manual repricing of claims, forms processing, provider table maintenance, fraud detection, etc.

10.     EOB Processing Services

We will provide a comprehensive EOB that includes all the information on the health insurance that has been processed by the insurer and what portion of it has been covered. We’ll help you understand the invoice and benefits without sounding too technical.

 

 

 

 

11.     Pre-Visit RCM Services

During this phase, we cover a host of services which can help you easily screen patients and record their details for faster processing down the line. We ensure all details are captured accurately and securely and screened for mismatches and mistakes. We offer -

  • Appointment and Scheduling
  • Demo Entry (Insurance and Patient Information)
  • Patient Registration
  • Referral Verification
  • Insurance Eligibility Verification (Online portal verification, real-time verification, and phone calls)
  • Prior-authorization
  • Patient Indexing
  • Batch Preparation
  • Payment Batch Preparation

12.     Post-Visit RCM Services

Once the patient has been discharged or has submitted his insurance claims, we help to follow up and trace the exact amounts requested, while liaising with the insurance provider, if required. Our services include -

  • Medical Coding
  • Medical Coding Audit
  • Charge Entry
  • Charge Validation
    • CCI Edit validation
    • ICD-10 code validation
    • CPT/HCPCS code & modifier validation
  • Claims Filing
  • Electronic Payment Posting
    • ERA & EOB posting
    • Daily log report
  • Manual Payment Posting
  • Denial Posting
  • Denial Management
    • Identify major reasons
    • Tracking and trend analysis
    • In-depth analytics
  • Account Receivables Management
    • In-depth analysis of outstanding claims
    • Follow up with insurance providers
    • Appeals & follow-up appeals
  • Denial Follow-up
  • Claim Dispute Verification

13.     RCM Support Services

Along with the above-mentioned services, we also provide a host of support services which can help you streamline and optimize your existing revenue cycle while benefiting from better cost-savings and increased customer satisfaction. Our services include -

  • Revenue Improvement Services
  • Claim Conversion
  • Custom Report Generation
    • Payment and charge reports
    • Procedures and diagnosis reports
    • Payment reimbursement report generation
    • Lockbox deposit reconciliation
    • Payor detail analysis
  • Claims Corrections and Refiling
  • Electronic Secondary Claims Transmission
  • Manual Secondary Claims Transmission
  • Provider Enrollment
  • EMR Clinical Documentation and Reporting
  • Patient Statements (Inpatient and Outpatient)
  • Patient Credit Status Report
  • Collection Processing
  • Bad Debt Follow-up
  • Balance Adjustment
  • Clinical Documentation Improvement (CDI)

 

 

 

;
;