DME SERVICES
Revenue cycle management (RCM) is a process used by healthcare providers to track the revenue from patients, starting from their initial appointment with the healthcare system to their final payment of balance. The major processes that comprise the revenue cycle management, which are carried out at RND, are – sorting of incoming faxes, data entry, intake, insurance verification, prior authorization, sales order creation, billing, accounts receivables followup, and payment posting. RCM ensures a steady flow of revenue for the healthcare providers.
RCM encompasses everything from determining patient insurance eligibility and collecting co-pays to properly code claims using ICD-10. Time management and efficiency play pivotal roles in RCM, and a physician’s or hospital’s choice of an EMR will largely center on how their RCM is implemented.
LIST OF RCM SERVICES
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Fax documentation
Reviewing the received member faxes from referral sources, determine the missing medical documents and forward to verification based on the prescription.
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Intake
Process patient fax from Doctor’s office, create account for the patient in the client tool, complete verification, initiate authorization and log the approved prior authorization.
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Sorting/Filing
All the clinical records received from doctor's office are filed in respective folders for future reference. New folders are created for new patients with all demographic details.
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Insurance Verification
Calls are made to the insurance company to check for patient's individual and family Benefits, policy termination date and coverage limit to determine whether the patient is eligible for machine/supplies.
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Pre Auth/Pre cert
Pre cert is obtained from the insurance company based on the patient's usage of the machine. This process will ease the submission of claims and guarantees payment without any further delay.
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MCR Checklist
All documents are checked and ensured that available documents are as per the Medicare approved criteria.
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CMN Follow-up
Calling patients or doctor’s office to get the missing necessary medical documents for approval of Shipment/supplies.
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Shipping Ticket/order entry
Once insurance is verified, based on the insurance eligibility and patient's request, shipping ticket is created for the eligible machine and supplies.
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Initial Order
When a new patient goes to a provider for getting equipment or supplies, we check eligibility and other mandatory documents like prescription and add the required supplies.
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Order Processing/Resupply
When a new patient goes to a provider for getting equipment or supplies, we check eligibility and other mandatory documents like prescription and add the required supplies.
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Payment posting
We are posting payments received from insurance and patient into client application in both electronic and manual payments.
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AR Follow-up
Analyzing the denied claims and probing for the exact reason and resubmitting it to the insurance carrier with the necessary corrections.
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Returns refunds
Refunding the payment for the returned supplies to the patient and the insurance company. Refunding the over payment made by the insurance and rebilling the extra amount recouped by the insurance.
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Patient Calling
Calls are made to patients intimating them that they are eligible for their resupplies based on their allowables.
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Inbound Calling
Attending incoming calls from patients regarding billing, supplies and other queries.
Benefits OF PARTNERING WITH US
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Zero set up cost
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Improve cash flow cycle
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Saving more than 60% on operating costs
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Quick support ensuring faster turnaround time
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Experienced personnel will handle your revenue cycle management
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Continual follow up of your bills and records for better revenue collection.
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HIPAA compliant proven processes for high performance revenue cycles.
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State-of-the-art software and technologies for a highly productive functioning of your revenue cycle management.
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Risk free business support services ensured by stringent information security policies and practices.